10 Barriers To Recovery From Lyme DiseaseWelcome to part two of my ten-week series – 10 Barriers to Recovery From Lyme Disease.  Today I’m going to talk about biofilm.

Biofilm is the term for a colony of bacteria that clump together and surround themselves with a mucopolysaccharide matrix. In other words, the bacteria immerse themselves in a slimy, goo-like substance, and in there they can live, replicate, feed, and live happily ever after, safely shielded from the immune system and from anti-microbial agents such as antibiotics and herbs. Furthermore, bacteria use a system called quorum sensing, which allows for cell-to-cell communication and strengthens their network. They also utilize a protein from the blood called fibrinogen, which they convert to fibrin to strengthen their network.

Biofilm exists in many different contexts, it is not specific to Lyme. Plaque formation in the mouth that causes cavities and periodontal disease involves colonies of oral bacteria in biofilm. Biofilms occur in hospital settings, for example, bacterial colonies can adhere to tubing on catheters or other internal medical devices.

Eva Sapi PhD is a researcher from the University of New Haven who has done extensive research on biofilm and Lyme disease. She found a handful of solutions to address biofilm. Her research showed that a combination of the herbs samento and banderol can help to break down biofilm. The other treatment options are enzyme-based substances such as lumbrokinase and nattokinase. These literally eat through the “goo” so that the bugs can be revealed, rendering them more susceptible to antimicrobials. Sapi’s research found that lumbrokinase is significantly more effective than nattokinase in this category (I use the Boulouke Lumbrokinase which is considered the highest quality and potency).

Her research also found that the medication tinidazole may have activity against biofilm. Tinidazole is also shown to have effect against all three forms of the Borrelia bacteria – the spirochete forms, the cell-wall deficient forms and the cyst forms. So tinidazole is a really worthwhile drug in Lyme treatment, even though it can be quite heavy going for the patient!

Biofilms contain heavy metals too, so logic follows that chelating agents such as EDTA can bind up the metals, pulling them out of the biofilm and making it less stable. There are minerals such as calcium and magnesium in biofilm, giving rise to a theory that restricting those minerals is important. My issue with this is that many Lyme patients rely on magnesium, in particular, to help with muscle aches, cramps and twitches, constipation, sleep issues and so on. Therefore, I do not typically restrict magnesium for these reasons.

I do not typically start biofilm agents early in treatment. Opening up biofilm can expose more bugs, which can then be killed off by antimicrobials. While one might think this is a good thing, in early days of treatment when the initial Herxheimer reactions are heightened, it can be too much. I like to get 2-3 months of treatment under the belt, at least, before introducing biofilm agents.

Biofilm is an important consideration in Lyme treatment. I believe that every patient should address biofilms, especially when a patient is not improving the way we would expect them to.  Having those bacteria trapped in gooey stuff that antimicrobials and immune cells can’t get to could be a major factor hindering progress in treatment.