Bacterial Biofilms with Dr. Paul Anderson: Rational Wellness Podcast 210

Dr. Paul Anderson discusses Bacterial Biofilms and How to Break Them with Dr. Ben Weitz.

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Podcast Highlights

2:19  Biofilms are a way that microorganisms like bacteria protect their colonies.  Biofilms exist in marine environments, in the mouth as plaque, and in the gut.  But we would not want to eliminate all of the biofilms, because some are good.  We want to open up the pathogenic ones so that our immune system and treatments can interact with the bad bugs.

5:04  Testing for biofilms at present is very expensive and is not readily available to clinicians. If you have patients who are chronically ill with gut problems, you should assume that there are likely biofilms and employ some biofilm strategies and if you have been sick for 2 years or more, you probably have some advanced biofilms that need to be addressed.

7:43  Biofilms are generally made by bacteria, such as pseudomonas, which tends to make biofilms like crazy.  Once the biofilm is constructed, fungus and other organisms like viruses may take advantage of it.  The biofilm protects the bacteria and other microorganisms from being seen by the immune system.

9:51  Biofilms are made of a protein mucoid portion with a lattice structure of minerals.  As biofilms stick around longer, the scaffolding and the structure gets thicker and thicker.  A lot of SIBO patients likely have biofilms since using biofilm treatment strategies have been found to be helpful in cases of recalcitrant SIBO.

13:40  There are normal, healthy biofilms, like the mucosal layer of the gut, so our goal is not to eradicate all biofilm but to open up the pathogenic ones.  When we are successful in breaking open a pathogenic biofilm and the immune system is coming into contact with these bacteria for the first time, so there is likely to be a large immunological reaction, so this may make sick patients much worse for a short period of time.  The way to avoid damaging the good biofilms is to do some gut and flora repair at the same time that we are breaking biofilms and eradicating pathogenic bacteria.

16:01  Some other prominent Functional Medicine practitioners have told me that some of the common herbs that we use to kill bacterial overgrowth and pathogenic bacteria, like oregano and berberine, can also damage the healthy bacteria in the microbiome in much the way to antibiotics can, so I asked Dr. Anderson if he has seen this to be the case?  Dr. Anderson said that he has generally not seen this to be the case and this is partially because herbs are gentler in their killing and they are less likely to block a specific pathway the way that antibiotics do and herbs are more broad spectrum and work through a number of different mechanisms.

20:09  Breaking up biofilms. Phase one biofilms are like a stick built tract house and these can often be broken up with common herbs that are part of the diets of many native cultures and most of them did not develop a lot of GI microbial problems.  This stops the nasty, phase II biofilms from forming, which are like steel frame skyscrapers that are very difficult to break down. This is why we can use herbs and spices to break down most phase I biofilms, before phase II biofilms are formed.  When we do confront phase II biofilms, sometimes certain herbal products like Biocidin can be effective at breaking them up. 

28:12  When herbal products are not effective at breaking up biofilms, we may get some benefit with special enzymes like Interfase Plus, which also includes EDTA, which is a chelating agent. Biofilms have two parts, a protein structure and a mineral matrix. The idea is that the EDTA would disrupt the mineral matrix and the enzymes would disrupt the actual film, the proteinaceous stuff. 

33:02  In order to break up more complex biofilms Dr. Anderson has developed a few products, including his Biofilm Phase II from Priority One that includes Bismuth subnitrate, Alpha lipoic acid, and Black cumin seed.  The recommended dosage is 1-3 capsules per day away from food.  Dr. Anderson has also developed a prescription product that he calls Biosolve PA, which must be made by a compounding pharmacy that contains bismuth subnitrate 200 mg, DMSA or DMPS 25 mg, and Alpha Lipoic acid 100 mg.  The recommended dosage is to start with 1 cap per day away from food for one week as a test dose, followed by 1-4 caps per day away from food 3-5 times per week for 2 to 4 months.

42:10  When to use a biofilm strategy on a typical SIBO case.  With the average SIBO case who has not been sick for a long time, if you use your standard SIBO protocols including diet, motility support, antimicrobials, etc. and if you’re not seeing resolution (patients get better) in the normal time period or if as soon as they stop treating even with good diet control, it comes right back, then you should implement biofilm agents.  Keep in mind also that many of the herbal antimicrobials have some biofilm breaking properties.  If you do break open the biofilms, then your adrenals will will take a hit and crash, so you should implement some adrenal support as well, which will calm and modulate the immune response.  You can use some adaptogenic herbs like rhodiola and ashwagandha or if the adrenals are really trashed, then you should use some adrenal glandulars and some licorice for 2-4 weeks.


Dr. Paul Anderson is a naturopathic physician, Medical Director & Founder of Anderson Medical Specialty Associates (AMSA). He is a recognized authority in the field of integrative cancer research and the treatment of chronic diseases, genomic conditions, and auto-immune and infectious disorders.  Dr. Anderson has written three books, Outside the Box Cancer Therapies: Alternative Therapies That Treat and Prevent Cancer, which he wrote with Mark Stengler, Cancer, The Journey From Diagnosis to Empowerment, and the recently released Cancer, The Journey from Diagnosis to Empowerment. Dr. Anderson also offers 80 different courses on a wide variety of aspects of a Naturopathic practice, including on biofilms at ConsultDrAnderson.comDr. Anderson also has a hub website, DrANow.  Here is a biofilm research review paper written by Dr. Anderson: BIOFILMS: WHAT HAVE WE LEARNED FROM THE RESEARCH?

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

Dr. Weitz:                            Hey. This is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

Hello, Rational Wellness Podcasters. Today, our topic is biofilm with Dr. Paul Anderson. For those of us who have suffered with or who treat patients suffering with gut infections, we may find that they don’t resolve as easily as we hoped or recur after successful treatment, and we are often looking for what could have been done different, what we might have missed. One of the possibilities is that there may be biofilms that provide protection and make eradicating the pathogenic or offending bacteria or fungi more difficult.  Some of us may have considered this option, and may have taken or employed inpatient care with the use of nutritional agents that are supposed to break the biofilms, and while some have found these to be helpful, many of us have found that sometimes they help, sometimes they make no appreciable difference. This is why I’ve asked Dr. Paul Anderson to join us to give us some insights into the latest research into gut biofilms and what to do about them.

Dr. Paul Anderson is a naturopathic physician, medical director and founder of Anderson Medical Specialty Associates. He’s a recognized authority in the field of integrative cancer research, and the treatment of chronic diseases, genomic conditions, and autoimmune and infectious disorders. Dr. Anderson has recently released a book, Cancer: The Journey from Diagnosis to Empowerment. Dr. Anderson also offers 80 different courses on a wide variety of aspects of a naturopathic practice, including on biofilms at consultdranderson.com. Dr. Anderson, thank you so much for joining us today.

Dr. Anderson:                    Thanks for having me. It’s great.

Dr. Weitz:                          Absolutely. So, maybe we could start with what are biofilms, and how often do they exist.

Dr. Anderson:                    All right. Yeah. That’s the best place to start. So, they’re all over in nature. They are not just something humans have. As a matter of fact, they’re more common in marine environments, so under the water, and that’s the first place, I think, we really characterize them. So, if we just take that for just a moment, I know we’re talking about people here, but biofilms grow in marine environments to protect colonies of usually microorganisms. If you think about it, a lot of times that can be for symbiotic reasons with the environment around it.  So, for example, you’re under water, you might need certain microbes to maintain something, a plant life or something. If they’re in a biofilm, they’re kept in a location, they’re protected, and they’re not going to be drifting away and going around.  If you look at human biofilm information, the first place we really characterize it in people was on our teeth. So, dentists have known about biofilms for a long time. As a matter of fact, a lot of the goal of some of toothcare like brushing and other things is to keep the biofilms disturbed so you don’t get-

Dr. Weitz:                          By the way, that’s often referred to as plaque.

Dr. Anderson:                    Yeah. So, most of us without knowing it are treating biofilms in our mouth by brushing our teeth and going to the dentist. So, I think it’s important to say because I have, now that I’ve been working with this for a long time doing a lot of patient education and doctor education, I think it’s important to remember just like in the marine environments, there’s a certain amount of biofilm that’s normal and healthy in people and other mammals. It’s important to remember, just like our natural microbiome that can be healthy or medium or really unhealthy, biofilms are that way as well.

So, there is a certain amount that are very normal and persist in humans that don’t cause any trouble at all. So, just like it’s never our goal to eradicate all the microbes in the gut because that would kill us, actually, we want to get back to the good ones, we’re not really trying to remove the biofilms. We’re trying to open up the pathogenic ones and then allow the immune system and maybe treatments to interact with the bad bugs. So, that’s the big picture around human biofilms and the context I like to have.

Dr. Weitz:                          So, how do we know that biofilms are there or should we just assume that when there’s a gut infection that they’re there?

Dr. Anderson:                    That’s a big question clinically to wrestle with. There are certain tests that can be done for biofilms. I mean, the reason that we know that they exist within humans is because of research that had been done, of course, but a lot of that testing is not terribly available to clinicians. A lot of the tests that might be helpful with looking for biofilms are also by the time you have a patient sick enough to spend that much money on a test, they’re all going to be positive anyway. So, we would probably spend it on treatment.

I think what’s important with regard to that is what I saw clinically and what really led me into, I knew a little bit about biofilms if we’re going back a number of years, and I kept thinking, “There’s got to be more to this,” because what I had been taught about them is what we all were taught. It was pretty rudimentary. It’s okay. It’s state-of-the-art, but there’s obviously a deeper well.  Well, I had a really smart patient come in who I’d been seeing for a long time, and she would often just throw things out, had nothing to do with her case. One time she came in and she says, “Have you looked into biofilms much?”  I said, “Well, a while ago, but I’ve been doing other things.”   She said, “If you have so many chronically ill people, you should probably look into biofilms a little deeper.” She said, “I bet you’d find stuff.”  Indeed, I started finding. There’ve been a mushrooming of science around biofilms because of resistant infections and people leaving hospitals with untreatable infections and all this. So, that led to this whole discovery that, number one, biofilms can be normal and healthy, but the rule I tended to find and follow was if the patient has been ill for any amount of time, just like your microbiome gets thrown off, you’ve got some bad biofilms with the good ones. If they’ve been sick two, three, five, 10, 20 years, you probably got some real advanced biofilms, and that’s nothing. Biofilms go from the normal healthy ones to what I call a single family home to a skyscraper. They literally are like that.   So, the normal healthy ones are like pop tents. They’re made to be symbiotic. The pathogenic ones can either be straightforward like a stick house or literally a hive of so many microbes you couldn’t even believe it. Yeah.

Dr. Weitz:                          Are biofilms equally present in fungus growth as they are in bacteria, and are bacterial biofilms different than fungal biofilms?

Dr. Anderson:                    Yes. That’s a really good question because it gets misconstrued a lot.

Dr. Weitz:                          By the way, I just spoke to Dr. Sam Rahbar a little while ago. He suggested that question.

Dr. Anderson:                    Okay. Yeah. That’s a good one. All right. Yeah. No. It’s one of those things where you could look at the question from two ways and answer it two different directions, but if we look from the top down, most biofilms are created by bacteria, okay? The actual building of the structure is largely bacterial. There can be other microbes, but the thing that makes them pathogenic is they recruit other microbial friends to come. So, you might have started, for example, pseudomonas is a really common organism that if it’s a small amount, no problem, gets in the wrong place, big problem.

Well, pseudomonas makes biofilms like crazy, which is why when you get a pseudomonal pneumonia it’s hard to get rid of. Pseudomonas, you get a lot of that growing in your gut. It starts as a biofilm, but then pretty soon, you’ve got extra clostridia in there. You can get fungus joining in, viruses, parasites. The way they talk about biofilms now, and most of this research is funded actually by the US Military and the CDC looking at resistant infections because that’s of great interest to them, of course. What they found was that the sicker the person is, the more resistant the infection, the more variety of microbes live together, and they call it a hive effect. So, now, the biofilm is its own pathogen, and it might be part fungal, part viral, and then they alter DNA, which is even not as good because they become superbugs.  So, the biofilm is often, I don’t know what the stats are.

Dr. Weitz:                          What is the biofilm actually made of?

Dr. Anderson:                    Yeah. So, it’s a matrix. The idea of biofilm sounds slimy and you think about plaques, they’re slimy, but, really, they’re a dual matrix. There’s a protein mucoid portion, and then there’s actually a lattice structure that’s base minerals, okay? When they get together, like I was saying, you’ve got the stick built house versus the skyscraper, they’re just thinner, weaker, but they might still have some fungus and parasites and bacteria all living healthy. You’re sick a long time and sometimes you eradicate the good bugs and they just keep getting bigger because they’re permissive.  No one is telling them to stop.  So, the scaffolding and the structure just gets thicker and thicker and thicker, which is also why in later infections and a lot of SIBO patients and other just chronic gut problems till you break through that, you often are chasing your tail with the microbiome.


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Dr. Weitz:                          So, do you think SIBO patients often have a biofilm issue?

Dr. Anderson:                    Yeah. One of the reasons that I came in to the world of speaking at SIBO conferences was all around biofilms, and it wasn’t because I was pitching the idea to the SIBO community. Well, I like to tell people I actually predate SIBO. We were treating it. We didn’t know what it was called, and sometimes doing better than others, but the reason I started to get asked to these things is some of the leaders in the SIBO world started to say, “We’re seeing this could be a biofilm-affected condition. We have no idea if treating it is going to help. Let’s take our patients that are not responsive and do some advanced biofilm treatment.”  They didn’t tell me this till later, and they said that with their recalcitrant patients that they just kept running into a treatment wall or cycling back to symptoms. Biofilm worked at a more advanced level, made a huge clinical difference. So, then they decided it was clinically worthwhile, so then they asked me to come talk about it.

Dr. Weitz:                          Now, isn’t the mucosal layer of the gut a biofilm with bacteria?

Dr. Anderson:                    Yeah, and that’s the normal healthy biofilm, yeah. It’s similar to the marine environment, where you may want, as we see in SIBO, you might want bacteria in one area and not in the other, and this is the way of keeping them in place. So, like I said, your goal is not to eradicate all biofilm, which would be hard to do anyway, but it’s just the pathogenic ones.  You want to get them open and have a combination of attacking what’s in there and also letting the immune system interact with it because the biofilm largely protects the immune system from seeing the bugs, which is why when they truly open in a sick person, we always warn the patient they’re going to probably react with a very large immunologic reaction that we want to then treat, not just let them be sick. That’s the immune system suddenly coming in to contact with bugs that it had been there the whole time but they couldn’t see it immunologically.

Dr. Weitz:                          We’re going to get to treatment in a couple of minutes, but how do we avoid damaging the healthy biofilms while eradicating the unhealthy biofilms?

Dr. Anderson:                    Yeah. Well, it’s a little bit like the discussion around we have to give some treatment orally for GI microbes we don’t want to be there. We’re naturally going to damage the good bacteria and the good flora that we want. So, in that case, what we’re usually doing is trying to support the gut health and replace the good flora. In the case of biofilms, it’s a similar logic. The normal healthy biofilm is created by having the most normal flora you can have.  So, what we usually recommend people do is biofilm treatment shouldn’t be forever. It really should have a time period. So, maybe you’re going to be more aggressive while you’re treating the biofilm and eradicating bugs, but your goal during is to do a little bit of supportive stuff for the gut and the flora and after a lot of support for the gut and the flora. That’s the best way because the body will naturally rebuild the good biofilms.

Dr. Weitz:                          By the way, on a related topic, many of us in the natural world are using various herbs to treat bacterial overgrowth and try to reduce bad bacteria. It’s come up several times whether or not taking these common herbs like oregano or berberine can actually damage the healthy bacteria. A lot of us have not really found that to be the case, but you would think logically anything that could kill bad bacteria could kill some of the good bacteria, too. What do you think of this story?

Dr. Anderson:                    Yeah. That’s something that-

Dr. Weitz:                          I mean, we all know that antibiotics are damaging the microbiome.

Dr. Anderson:                    Yeah. I think you characterized it the best way from my own personal experiences. For some reason, unless you’re using extremely high doses for long periods of time, I don’t see the disordering of the microbiome with oregano, berberine, olive leaf, any of those things that I do with an antimicrobial drug, and it’s partly strength and partly … You think about the way that most herbal things work. Yes, oregano is one of my favorites. It’s a good example. It’s got some antifungal effect, and a bacterial, and a parasite, and a viral. It does a little of everything. Berberine, really also.  In and amongst that, it’s not like where you give a penicillin and it blocks a very specific pathway and certain bacteria. Well, oregano is a little more of a master control. It depends who it interacts with. So, I think while you could damage the good flora with natural stuff, it’s harder. It’s way harder, clinically. I think it’s because they don’t work through one mechanism and because they’re a little gentler in their killing, although they can be pretty, you can stir a lot of stuff up with those, they’re a little bit gentler and probably a little more broad spectrum. You don’t deplete … If you think about a lot of antibacterial drugs are going to target most of your good flora, whereas these things are targeting a whole bunch of things and not just certain bacteria.  So, it’s the only way I can make sense of it in my mind because, clinically, I do use medications at times, I know in X number of days if I give an antifungal and an antibiotic or an antiparasite drug I’m going to have flora disruption if I don’t do something about it. If I give oregano and they’re on some GI support, I’m probably not going to get flora disruption. So, there’s obviously a difference.

Dr. Weitz:                            Yeah.  It certainly makes a lot of sense, and this comes up in discussions, especially SIBO discussions where we’re talking about what type of diet to use at the same time as treatment.  So, on one hand, you have Dr. Pimentel saying that when you use antibiotics like rifaximin, it’s important not to put the patient on say, for example, a low-FODMAP diet because the antibiotics work by interrupting the replicating cell wall of the bacteria.  So, you want the bacteria growing, and you don’t want to suppress their growth.  Whereas many of us in the natural world that use things like oregano and berberine find that it actually works better when you put the patient on maybe a low-FODMAP diet or remove some of the foods that are more likely to feed the bacteria.

Dr. Anderson:                    Yeah, and that really does speak to the…most antibiotic therapies have one or two mechanisms and that’s it, and most herbal therapies have more than five or more than 10. So, yeah, I do think that’s a big part of it.

Dr. Weitz:                          Right. So, now, when it comes to trying to break up biofilms, let’s start with are there any dietary or are there any foods that can break up biofilms?

Dr. Anderson:                    Yeah, and for purposes of this discussion, we want to go back to the three stages, the pop tent, and the stick house and the skyscraper. Scientifically-

Dr. Weitz:                            I can’t help when I think about pop tents, I’m thinking of homeless people now because I live in Los Angeles and every time … There’s plenty of pop tents running now.

Dr. Anderson:                    Yeah, that’s true. Yeah. That’s true. I wasn’t thinking about that, but it’s still good analogy. So, we’re going to rebuild the normal pop tent ones and all that later. So, what we’re concerned about with therapy is what we call phase one or what I call a stick-built, a tract house. It’s a good structure bigger than the pop tent but easier to get in to. Phase two biofilms, and this is something, again, that all this government money research showed with drug resistance and postsurgical wounds, all that stuff. Phase two biofilms are the more aggressive ones and are literally like skyscrapers. They have more bugs in them.  So, what you do to prevent the good ones from going bad crosses over into getting in to the phase one, the lower house, but it doesn’t do anything for the phase two, the bigger, more pathogenic ones.

 So, I often wonder just historically why do most endemic societies that all have their own foods and spices and herbs and all that, they’re different everywhere in the world, but most of them didn’t develop a lot of GI microbial problems. One of the reasons is is that, and it doesn’t matter where you look in the world, even in the north of Scandinavia or Siberia or wherever where we think of it being desolate and barren, they have a lot of evergreen type herbs and things that they use in their cooking. You go to India, you’ve got a whole other plethora of things. You go to North America, different ones. We’re talking about original native peoples.  Well, if you look at any part of the world and the common spices and herbs that they used and they ate every day, almost all of them are anti-phase one biofilm agents that we know now. So, you could look at say cumin, you could look at rosemary, thyme, sage, all of those things. Think about it. It’s like if you don’t have a problem to start with and you got the nice normal healthy biofilms, eating every day a little bit of herb, spice or whatever is going through, number one, whatever bugs came in on your food are less likely to bug you up, but, also, it’s just maintenance to stop the nasty biofilms from forming.

So, in modern therapies, what I often focus people towards is for prevention, let’s say hopefully you don’t have any problems, adding herbs and spices to your food that are more native and the cool thing now is you don’t have to go to your own heritage. If you like curries, you can eat those. If you like the more Nordic things, you can eat that. It doesn’t matter, but having that actually as part of your diet is something that we’ve often forgot about as a therapy, and as a preventive maintenance, it’s great.

When we get to people who are starting to deal with problems, one of the reasons why more medicinal doses of herbs I think do a lot of what they do is you give oregano or a mixture of maybe there’s products that have some oregano and rosemary or some other things, part of what that’s doing is antimicrobial, but incidentally without thinking about it, you’re also beating down on those phase one biofilms. So, eating your prevention is number one, if you can, and then we extrapolate that to herbal doses and you’re still treating the lower biofilms.  The problem elite people have is most of us were taught biofilms that are pathogenic are these amorphous things. We didn’t realize there was bigger and little ones, and then we’re told, “Well, if the herbs don’t work, enzymes or EDTA or whatever would probably get in to the rest of it.” What we found is partly but not really when they get really bad. So, that’s where treatments peter out.

Dr. Weitz:                          It seemed like for a while it was enzymes, and then people kept coming up with a different and, “No, you need this brush broader enzyme. No, you need this kind of enzyme,” right?

Dr. Anderson:                    Yeah, and that’s not to say enzymes don’t work. They work really well in that setting of the early pathogenic biofilms.

Dr. Weitz:                          Now, how do we point which enzymes and is mixing EDTA and InterFace Plus, is that one of the best things on biofilm strategies?

Dr. Anderson:                    Yeah. What I would do often with people is if an herbal approach wasn’t seeming to break through, but they hadn’t been sick for years and it didn’t seem like a super complex case, and maybe even something like … I’ve often had good effect with say Biocidin in those cases. I see Biocidin straddling between phase one and phase two almost, but InterFase Plus where it’s got some EDTA-

Dr. Weitz:                          Maybe you could explain what Biocidin is.

Dr. Anderson:                    Yeah. So, Biocidin, and it’s I believe also the company name, Biocidin has a couple of products, but one was really an early idea at mixing antimicrobial herbs and biofilm-disrupting herbs that turn out to be the same thing in a fairly concentrated form.

Dr. Weitz:                          The funny thing about that product is it’s one of those products where they don’t tell you exactly how much oregano. It has stuff mixed in there, too, like polyphenols, knotweed, which is resveratrol, and things that you don’t even think about as having playing a role in eradicating bacteria.

Dr. Anderson:                    Yeah. I don’t work for them or anything. I’m just throwing that out there.

Dr. Weitz:                          I think the company is called Bio-Botanical.

Dr. Anderson:                    Bio-Botanical, yes. There you go. I bring it up, though, because that’s one of the most common questions people ask me is where does Biocidin fit in.

Dr. Weitz:                          Right, because they do market it as breaking up biofilms.

Dr. Anderson:                    Yeah, and they do have some internal data that would say that that happens.  I’ve seen it clinically worked.  What I will also say as you’ve probably seen, people either love or hate that product for whatever reason.  There’s a lot of reasons, but I’ve had a lot of people.  In my practice, people would tend to come in after they’d tried a lot of this stuff.  So, I had a lot less entry level patients.  So, usually, I was saying, “Well, I failed InterFase,” or “I failed Biocidin,” or whatever or “Someone put me on lumbrokinase or natto,” or whatever.

Dr. Weitz:                          Those are special enzymes.

Dr. Anderson:                    Yeah. So, the way I look at it is it was always worth trying those things, but if you think about the goal, not that it’s the best, it’s a good attempt at a good biofilm product.  If you look at the mixture of the enzymes and the EDTA like in InterFase Plus, the reason it gets a little more work done than maybe some of the herbal alone things is we go back to what is a biofilm and it’s got two parts.  Almost like bone where you have the mineral matrix and then the proteins.  It’s the same with the biofilm.  So, the idea is that the EDTA would disrupt the mineral matrix and then the enzymes would disrupt the actual film, the proteinaceous stuff. So, it makes a lot of sense.  Now, giving just enzymes alone probably helps open up the lower, the phase one things. Giving EDTA alone can disrupt them because you’re … If we go to the house analogy, the EDTA would maybe pull the siding off and make it a little easier to get inside, and the enzymes might break the windows out or something. So, anything that your immune system can see it will start to work.

Dr. Weitz:                          EDTA is like a chelating agent.

Dr. Anderson:                    It’s a chelating agent, which will, of course, bind to our minerals. Now, the reason EDTA was originally thought of to be used and we actually use it a lot with biofilms, but, number one, EDTA was used in a lot of marine biology experiments with biofilms for that reason. It would go in and disrupt the mineral part of the biofilm, and then the biofilm would fall off whatever it was.  Same with teeth. They get a really aggressive plaquing biofilm problem or if they’re doing a prep where they’ve done something. They’ll often do an EDTA prep to just clear out any biofilm that’s microscopic. So, EDTA is a chelator, does work really well in that setting. It doesn’t absorb from your gut in its plain form very well, which makes it nice because you’re not getting a systemic effect. It’s a gut effect.

What we saw clinically was even when you got to, say, again, I don’t work for these folks either, but InterFace Plus, great product with enzymes and EDTA mixed together. We had some people where that wouldn’t even really move the needle. That’s where a lot of the government research that I came upon and then since then I’ve met a lot of these researchers who worked for the military and the drug companies.  That’s where going to this next level of what we call a phase two biofilm support or product made a huge difference because it gets into the more concrete structure like the High Rise. The whole goal is not to blow it up. It’s to open it up enough that your immune system says, “Oh, gee! We don’t like these bugs,” or your herbal products can actually get to those bugs and treat them.


Dr. Weitz:                            I’d like to interrupt this fascinating discussion we’re having for another few minutes to tell you about another really exciting product that has changed my life and the life of my family, especially as it pertains to getting good quality sleep. It’s something called the chiliPAD, C-H-I-L-I-P-A-D. It can be found at the website chilisleep.com, which is C-H-I-L-I-S-L-E-E-P dot com.

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If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.


Dr. Weitz:                          So, how do we break up the more complex biofilms?

Dr. Anderson:                    Yes. So, when you get to the phase two, the skyscraper types, there’s a few different strategies, but the strategy that’s actually came out way ahead as far as just efficacy. One of the things people should know is this research was, okay, it was funded by the government, but it was implemented and used by the pharmaceutical industry to develop treatment so you wouldn’t leave the hospital with biofilms because that’s a huge problem in a post-surgery, in post-trauma. Of course, you don’t want to tell everyone, “Gee! Hey, come to the hospital. You’re going to leave with a great biofilm.”

Dr. Weitz:                          It’s like somebody has a hip replacement and there’s biofilms surrounding the replacement.

Dr. Anderson:                    Yeah. You get your surgery and it’s just the nature of the beast. So, now, what they’re doing is they have this whole strata of biofilm treatments that they do automatically around surgeries to keep you from going home with biofilms, right?  The reason I bring this up is that the research was not just theoretical. It’s actually turned into what I’m going to tell you phase two biofilms, there are now drugs either in development or being used that are analogs to what I’m going to tell you about. The reason I’m not in jail or anything is as someone who could have sued me told me what I published was all based on government research and it was all in the public domain, and the drug companies went a step above the chemistry that I proposed from the research so that they could patent it.  So, they don’t care … The one person was very upset for a couple of years with me. He had no reason to be because he’ll be a zillionaire, but he thought I spilled the beans or something, but their goal is a whole bunch of real super targeted things. So, there’s another level beyond what I’m about to talk about that would be hospital-based.

What they found was, and it’s important to remember it’s not the individual things I’m talking about because, individually, they’re great biofilm agents, too. So, they started to look, the government did, “What are strong biofilm agents that we know about from history and could we combine them and make them a super biofilm agent?”  One, which we know from H. pylori and other stuff is bismuth, and there’s bismuth in a lot of the protocols or some SIBO protocols, and bismuth, among other things in addition to changing the pH and the GI tract, is a biofilm disruptor. Now, a problem with bismuth is at high doses it’s a toxic metal, too. So, we have to be careful.  Well, then they started looking and they said, “Okay. So, bismuth has these qualities,” and they looked at a lot of stuff, but I’m shortening the story. Then they said, “Well, we know that if we give people what we call a monothiol, a single sulfur like N-acetylcysteine, NAC or even alpha-lipoic acid, that has some biofilm effect in the gut. What if we took a stronger sulfur compound, a stronger file? How would that work?”

So, then they look at dithiols like DMSA and DMPS, the chelators. Well, those are great, too, and they actually break biofilms like EDTA does. They go after the mineral matrix. The problem being if you’ve taken a lot of DMSA or DMPS you’re going to chelate yourself, too, and if you’re not, well, you can deplete minerals and other things.  So, then they started to do these combination things, and it turns out if you take a dithiol like DMPS or DMSA and bismuth, especially bismuth subnitrate, which is the one that a lot of SIBO protocols use. Bismuth subnitrate is super reactive. You put them together as a powder and they join, and they make a new molecule. So, it’s no longer bismuth, it’s no longer DMPS. It’s called a bismuthiol BT, bisthiol complex. Turns out bisthiols are what they landed on as the safest long-term and most effective advanced biofilm attacker, and they have ton of data on that.  Now, that spun off, as I said, in the pharmaceutical versions that are way more advanced than anyone could ever make for outpatient use. So, what I started to do was just, because at this point we had a lot of patients who are trying different chelators and high-dose NAC and oregano NAC, everything. So, I got a company pharmacy to make what we could get as a bismuthiol, which happen to be DMPS and bismuth subnitrate.

Now, why didn’t I pick? Because if you look at the research, there’s stronger thiols and even better bismuth that make a tighter bond. I had my pharmacy people try and source all the stronger ones and the government has sequestered all of them for military use. So, a pharmacy that 10 years ago could buy any of those, can’t buy any of them now, and I guess it makes sense because we’ve been in wars and biofilms are a big problem with battlefield wounds.  So, the reason that we settled on DMSA or DMPS and bismuth subnitrate is those were still available in the public domain. Then I made a version that didn’t require prescription items. So, the DMPS and DMSA you have to get by a prescription. Made an over-the-counter version and the company, an American company and Canada both make that over-the-counter one, and it is admittedly weaker because it doesn’t have the super strong dithiol in it, but it’s still quite effective. What we did is we used ALA, alpha-lipoic acid, bismuth subnitrate, and then we added black seed, the nigella sativa, which nigella sativa is actually a pretty strong biofilm buster, stronger than most herbs, and it’s also antimicrobial. So, it’s a nice combo to get other.  I will say from clinical use using both-

Dr. Weitz:                          By the way, that’s the phase two biofilm product from Priority One.

Dr. Anderson:                    So, Priority One calls it biofilm phase two and because I don’t live in Canada, I can’t remember that there’s a supplement company that has that formula as well. So, just so folks know, and this also made people upset, but the prescription version is available anywhere, and it’s actually that biofilm webinar is no cost. If you go through Priority One, we’ll sponsor you to take the biofilm webinar, but I give the formula out. Any pharmacy that wants to get the stuff, they could. I should have, but I’ve never made a dime off of any of those prescription.  So, all of the drug version I put out into the public domain and there’s tens of thousands of doses doctors have prescribed with that. The OTC stuff, again, the people in Canada, it’s not patentable. I just said, “Here’s the formula. Canadians want this. Go ahead,” but I don’t remember who they are. It’s a big supplement company up there.

Dr. Weitz:                          So, if we’re going to apply a biofilm protocol as part of let’s say a SIBO treatment, should we do it first and then use the antimicrobials. We tried the antimicrobial, it’s not working, and then we kick in the biofilm. Do we just layer it on top? Do we halt the antimicrobial and say, “Let’s kill the biofilm first”? Is there any protocol when to use it, how to use it with relationship to the other products we may be using. We may be using a motility agent. We may be using-

Dr. Anderson:                    Right. Well, of course, that always goes back to what’s your clinical intuition with the case.

Dr. Weitz:                          Of course, yeah. The art of-

Dr. Anderson:                    Yeah, the art of medicine, but what I would say is let’s say you’re just taking a generic SIBO case. The average case, especially the SIBO specialist that I work with and collaborate with have told me is if they’re not a person who’s been sick a long time or had a lot of field treatment, so your average entry level SIBO, they will do the standard testing and then the standard protocols for what they find including diet, motility, all the stuff.  Then if they’re not seeing resolution in the normal time period, they start to see people get better or if as soon as they stop treating even with good diet control, it comes right back, then they will go and they’ll implement biofilm agents.

Now, keeping in mind that many of the herbal products people use with a standard SIBO protocol are phase one biofilm agents already. So, you’re always doing a little bit of biofilm work, but in the two cases of either recidivistic patients where you keep it in the wall and they keep circling back to start or the patient who’s had a bunch of failed therapies, they’ve been to three SIBO specialists and get a little bit better, and then they just backslide or they’ve been sick for 30 years, the SIBO specialist I talk to now will just take that whole group and put biofilm treatment in with their SIBO protocol.  Now, I do want to say because if you’re either a patient or a clinician and you’ve not run into this, it can be a little bit disturbing if you don’t know what you’re seeing or feeling if you’re the patient. If you truly break in to one of these bigger biofilms, and that is part of your problem.  The immune response can frighten the patient and confuse the doctor. We saw this early on. This one thing has got my attention because I’d never seen any of the other biofilm things create these reactions. With a lot of patients, especially with PANS, PANDAS or neuropsychiatric things where inflammation will inflame their brain as well. You have to be a little careful.

We would have patients where we’ve done all the other stuff, including InterFase and all those other things, and we put them on a bisthiol. Suddenly, they’re getting this big immune responses that they’d never had. Well, logically, if you’re not the patient, you say, “Well, okay. You’re opening a skyscraper worth of God knows what’s in that biofilm and your immune system is freaking out new, right? It’s never seen all this stuff. The problem for the patient and the doctor if they don’t understand it is that’s an immediate stressor. So, you have to come in and I … If you don’t know what to do in that situation, the two things I like to target, one is oregano or a real broad spectrum herb is usually what I would use when that happen because whoever is being released, oregano will probably kill part of them, right?   Then the adrenals take a huge hit when you get these big immune responses, and what we would notice with patients, even younger ones, is if we didn’t couple the broad spectrum herbal treatment with some aggressive adrenal support, even if they didn’t need it before, they need it temporarily to get them through, then it would crash their adrenals because it was just so much immune response. If you get the adrenal support in, it calms, modulates the immune response.

Dr. Weitz:                            When you say adrenal support, you mean adaptogenic herbs like rhodiola and ashwagandha or are you talking about actual support for the adrenals to produce more hormones like glandulars, like licorice.

Dr. Anderson:                    Yeah. It, again, depends on if before all this their adrenals were great, humming along, you didn’t need any adrenal support. I would usually start with adaptogenic mix and maybe a little bit of licorice, something like that. If they already were, their adrenals are whipped and you’re already working with their adrenals, then I would go and stack maybe a higher dose of licorice on top. I’ve had it require … So, let’s say they were doing adrenal herbs and B vitamins before and that was enough, I’ve had to add fairly high doses of glandulars and licorice for two to four weeks to just get them over the hump, and then you can wean them off of it. It doesn’t crash it. It’s a stress.  So, starting with zero adrenal support. Yeah, adaptogens, maybe a little bit of licorice, starting with adrenal support. You’re going to have to kick up glandulars and some of the stronger things. Yeah.

Dr. Weitz:                          You just mentioned brain, and I wonder, is the amyloid plaquing you see in a brain in patients with Alzheimer’s, is that a biofilm?

Dr. Anderson:                    Not really. It has some similarities. The reason I paused and went through the Rolodex was … So, research has gone on for 30 years, but now it’s getting a little more specific about infectious agents being resident in the brain. We didn’t think that was a thing with the glymphatic system not working and all that. The more of that builds up more inflammatory.  So, the reason I paused was I am pretty sure we’ll find a connection. There’s a theoretical connection, right? I’m pretty sure we’ll find a real connection. So, probably there’s some process going on there, but amyloid plaquing stuff, while probably a similar trigger and process, it’s different biologically, but I think between the brain immune system, the glymphatics, and all the stuff that the brain does that we used to know it did, I think the microbiome affecting the brain is going to need to be a bigger thing. So, we might wind up there. Yeah.

Dr. Weitz:                            Right. One of the hot topics in the natural world these days is peptides. Have you looked into, are there peptides that can help to disrupt biofilms for the patients who don’t respond to the other treatments?

Dr. Anderson:                    I’ve used both oral and injectable peptides to a degree. What I would say is that the family, and this is just more of a clinical observation as opposed to the ton of research about it, but the family of peptides that we consider thymic peptides I find to be the most supportive during any infectious treatment. That even goes back to before modern day, the cool peptides that we have now in the olden days. We used to use thymus extract and thymic proteins and all this stuff and everyone said, “Oh, that won’t work,” but actually it does. Even in the pre-modern peptide world, the Germans-

Dr. Weitz:                            We do that sometimes in our practice, where we can’t prescribe peptides and really high quality thymus gland extracts and-

Dr. Anderson:                    Yeah. The Germans were doing work with thymic extract-based stuff 30 years ago with cancer and chronic infections and things, and it does work. What I would say is if people are using the modern cool peptides, I call them the thymic ones, you do seem to get a little more specific effect from those, and because I had used thymus extracts of different forms for a long time, I’ll say, “Well, I wonder how much different it really is.” I think you can get a long way with different thymic products and-

Dr. Weitz:                          Is there a particular one that you would point practitioners to if they’re looking to-

Dr. Anderson:                    Again, I don’t work for any supplement, so if I mention it, I’m not getting anything from it, but-

Dr. Weitz:                          Well, you should.

Dr. Anderson:                    Yeah, one of these days. That’s a smart move. I’m blanking a little bit on names because they all run together for me, but between the one that most of us, of course, use the long time or the standard processed ones and then Bio, one of the Bio companies. Its name will come back to me that has a real similar glandular product lines. The bottom line is there does seem to be … I’ll just go to standard processed names because the ones I remember them best.

They have Thymex and then they have a cytosolic extract. There’s different levels of thymus. With big problems like infections and cancer and stuff, I would use often the most crude thymic peptide or thymic extract I could because it probably had more peptides and broader stuff. With recovery or chronic use or whatever, I often use the more isolated things.  In modern times, what I see is with the thymic peptide therapies, even the oral ones because they have the injectable kind and the oral kind, the oral ones really do have quite a bit of immune support that they provide. So, I think they have a good place, yeah.

Dr. Weitz:                          When using a biofilm agent, how long before we should see a response?

Dr. Anderson:                    So, keeping in mind like I mentioned, big immune response, you can get fever, inflammation, all the immune stuff, that’s one end of the spectrum of response. It can also be more mild like some GI upset and maybe more die-off type symptoms. Then it can be all the way over on you don’t have a perceptible immune reaction, although you are, but you might feel tired, feel brain fog. Some people feel a little anxious or depressed. It’s more of a cytokine response through the body. So, keeping in mind a change from baseline is what you’re looking for.

Dr. Weitz:                          Do the patients ever bypass all those and just feel better?

Dr. Anderson:                    A few people do, yeah, but I like to warn people that if they’re bad biofilms, you got some work to do once they open up. So, what I used to tell patients is if we get to the place where you need a phase two biofilm agent, like a bismuthiol, whether it’s over-the-counter or prescription, we’re going to mess with the dose a little bit there in the first week. Now, if you react the first day, we’ve got our answer, right? It would take a couple of weeks and increase the dose if you’re getting no response. In most patients, if they haven’t had a response by four to six weeks, I just tell them that we’re not turning over the right rock her.

Dr. Weitz:                          Four to six weeks. What would be the max dose you would use say for that biofilm product that’s available over-the-counter?

Dr. Anderson:                    Yeah. So, with that, because it’s not quite as potent as the prescription one, I mean, the prescription one we use this just one or maybe two with the person, and what I usually like to do is give them a week straight and then after that first week when we sort out are we in the ballpark or not, I like to cycle them and have them do four days on and three days off, and the reason being, it confuses the microbes because like with anything, if you just treat it and treat it and treat it, the microbes figure out what you’re doing and do that.  So, in the average patient, we put them on this cycle. I always start with one pill. Now, if they can, it’s better if they get a big glass of water and take it away from food because it’s going to, of course, not get mixed up with your food and all that. If people can’t pull that off, it’s still better that they take it than not take it. So, I’ll have them, say, take it with water before you eat, so it’s at least the first thing down digesting.  I usually start with one and let’s say it’s a bigger person, I might start with two, and then I’ve had people go up to four or five pills on their four days on and three days off. If we’re not getting anywhere-

Dr. Weitz:                          That would be two or three capsules twice a day?

Dr. Anderson:                    Yeah. If they can remember to do it twice a day or just all at one time because what happens is because the bismuth and the thiols in there are going to be, they’re going to absorb it or metabolize better, if they’re not with a whole bunch of other stuff. Sometimes if you’re dosing multiple times a day, and then they’re taking a bunch of other stuff, it’s hard to time.

Dr. Weitz:                          Is there a best time of a day to take it?

Dr. Anderson:                    We haven’t really found that it matters. It’s mostly just that you do take it. I have had people where you get … This is a happy circumstance. They’re taking nothing at near bedtime. They take breakfast, lunch, and dinner protocol and bedtime nothing. Bedtime is a great time to take it. Just make sure you take a full glass of water with it so it gets down.  If people have stomach upset and they’re trying to do it on empty stomach, just something to provide some cellulose like some celery or vegetables or something, they’re fine with it if the stomach gets upset by it, which is 10%-20% of people.

Dr. Weitz:                          Another question that came to me from another practitioner, we have a closed Facebook page for practitioners, Functional Medicine Discussion Group at Santa Monica, was they have a patient with chronic UTIs that are related to biofilms. Could the same product help with that?

Dr. Anderson:                    Yeah. Recurrent UTIs, in my experience, biofilms are really high on the list of the reasons the bugs would leave. If you think about it, biofilms like moist environments, teeth, gut, genitourinary tract, big places. We have had a lot of success using it because the complex of the bismuth and the thiol is largely eliminated through the kidneys and the bladder, anyway. So, it’s going to go there.  If people don’t immediately have access to the bismuthiol product, it’s not as strong, but what I found is N-acetylcysteine on its own because it processes through and is heavily urinarily excreted also can be a good bridging the gap. You get someone who calls you from out of state and they’re desperate. NAC is always a good one.  Biofilm doses of NAC usually are 2,000 mg two or three times a day for a couple of weeks, a pretty hefty dose. You have to warn on their pee will smell like rotten eggs, too, and stuff, but if you can get the bismuthiol product, it does get in there.  Now, again, if it’s someone who’s had a lifetime of cyclic urinary tract problems that keep killing and they come back, you probably got more intense biofilms and you might need to treat in cycles for a few months before you really get any traction. Someone who’s new to it and has just maybe got really sick and they built up some persistent urinary tract bugs, might only take four to six weeks, yeah.

Dr. Weitz:                          Okay. That’s been great, Paul. Any final thoughts for our listeners and viewers, and how can folks get a hold of your courses and you and your book?

Dr. Anderson:                    All those good things, yeah. So, I have a hub website that whatever people are interested they can find from there. It’s just D-R-A like Dr. A, dranow, D-R-A-N-O-W dot com. If you’re a clinician and you’re interested in CE, it’s got a link to that, and the book is linked to that. Also, what we could do if you email me, remind me, because Priority One does sponsor that biofilm webinar and it’s got a lot of information, I have a link for that, and there’s also a summary if people like to just read paper summaries that I wrote. I can send links to those, too, and you can maybe put them in the show notes and people can have that.

Dr. Weitz:                          Yeah, I’d be happy to.

Dr. Anderson:                    Cool.

Dr. Weitz:                          How about the book? The book is available at Barnes & Noble, Amazon?

Dr. Anderson:                    Any place you buy books in modern times it’s available. So, Cancer: The Journey from Diagnosis to Empowerment is literally about you and your care team, how do you process through it so you become empowered instead of a victimized patient, which does help in your outcomes with cancer. It’s available on every format I can think of. It’s on audiobook [inaudible 01:00:37] Kindle, and eBooks, paper if you like to read real books. Anybody can get that. If you can’t locate it, on the Dr. A Now site, there’s a book link and you can go there. Then it’s precursor book. So, Mind-Body is the second book, the journey book. The first book, Outside the Box Cancer Therapies, Mark Stengler and I wrote, is all about integrative therapies.  Now, we talk a little bit about Mind-Body. That’s mostly what do you do with all this information about herbs and this and that, when should you go integrative or whatever. So, that one is also available everywhere.

Dr. Weitz:                          Cool. Excellent. Yeah, and I’d love to have you back on some time and we can talk about the cancer.

Dr. Anderson:                    Love it. Yeah.

Dr. Weitz:                          Okay. Thank you, Dr. Anderson.

Dr. Anderson:                    Hey, thank you so much.


Dr. Weitz:                            Thank you, listeners, for making it all the way through this episode of the Rational Wellness Podcast. Please take a few minutes and go to Apple Podcast and give us a five-star ratings and review. That would really help us so more people can find us in their listing of health podcasts. I’d also like to let everybody know that I now have a few openings for new clients for nutritional consultations. If you’re interested, please call my office in Santa Monica at 310-395-3111. That’s 310-395-3111, and take one of the few openings we have now for individual consultation for nutrition with Dr. Ben Weitz. Thank you and see you next week.




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