Biofilms are the barriers that form around infections, tumours, injury and illness in the body to prevent their spread. In this sense, they protect us from disease. But these barriers can also prevent the immune system, medications and therapies from reaching these areas when they are needed, meaning that you won’t get better until the biofilms are addressed and eradicated.

Most people haven’t heard of biofilms, but they are considered as the important reasons for bacterial resistance and persistent infections and can have a significantly adverse effect on your health without intervention.

What are biofilms exactly?

It wasn’t until the early 1970s that scientists began to understand the major impact biofilm had on our health. Since then, much research has created a body of knowledge of how they are formed, how they act and how they respond to different treatments.

Biofilms are “a protective fence formed by microorganisms.” [1]

They are a sticky layer of bacteria, yeast, algae or parasites surrounded by gluey matrix of collagen, proteins, carbohydrates and DNA.

You will have encountered biofilm if you’ve slipped on a rock in a river, had some plaque on your teeth or pulled hair out of a drain. All these surfaces can be covered in biofilm.

Biofilm can also take up residence in the human body, mostly in the respiratory or digestive tract. The gut is an ideal environment for bacterial biofilms as it receives a continuous supply of nutrients and has a large surface area.

If you have an infection that won’t go away, biofilms may be the culprit as treatments won’t penetrate their protective layer.

A biofilm includes three components:

Microorganisms such as bacteria, fungi, and protozoans that generate an extracellular polymer to adhere, or stick, to one another or a surface.
A change in the microorganisms’ state from their single-celled “planktonic” state to their “biofilm state”. This alters their activities and how they function together, making them stronger as a unit.
An extracellular matrix or lattice made up of proteins, lipids, polysaccharides, and other molecules that aren’t cells. The matrix, or glue, protects the microorganisms inside it, stores the tools it needs to grow stronger [2]

Where do biofilms grow?

Biofilms occur in natural environments where there is moisture. Sites for biofilm formation include all kinds of surfaces: natural materials above and below ground, metals, plastics, medical implant materials. They also exist in plant and body tissue and can colonise implanted medical devices such as catheters and pacemakers.

Wherever you find a combination of moisture, nutrients and a surface, you are likely to find biofilm. [3]

Common biofilms

Common biofilms include:

H. pylori, species of Candida and other fungi
E. coli
dental plaque
other microbial and parasitic species, including Lyme disease

Illnesses associated with biofilms can include:

Chronic sinusitis
S. aureus skin infection
Antibiotic-associated enteritis caused by Clostridium difficile
Chronic UTIs
Candidiasis
Autistic behaviours caused by neurotoxins from Clostridium overgrowth

Biofilms in the body can also cause chronic lung infections in cystic fibrosis patients, chronic sinusitis and inflammatory bowel disease. [4]

How would you know if you had a biofilm present in your body?

You have an infection that has been verified by a laboratory test that you haven’t been able to clear
If you have previously tried to treat your IBS or IBD symptoms with antibiotics or antimicrobials and the symptoms have persisted. If you have a parasitic or bacterial infection or overgrowth, particularly those with a history of treatment resistance, it is very likely you have an associated biofilm infection. This is because an estimated 80% of all GI infections are caused by biofilm-producing microbes. [5]
If you have been sick for over one year
If your symptoms improve with antimicrobial treatment but they keep recurring. This commonly happens with chronic sinusitis – a patient feels great during treatment, but all symptoms return when treatment is discontinued.

How are biofilms diagnosed?

Biofilms, however, are difficult to diagnose and there are several issues that make them difficult to detect:

Bacteria within the biofilm are tucked away in the matrix so swabs and cultures often show up negative. Stool samples usually do not contain the biofilm bacteria either.
Biofilm samples within the GI tract are difficult to obtain. The procedure would require an invasive endoscope as well as knowledge of where the biofilm is located. What’s more, no current procedure to remove biofilm from the lining of the GI tract exists.
Biofilm bacteria are not easily cultured so even if you are able to obtain a sample, it may again test negative because of the microbes’ adapted lower nutrient requirements, rendering normal culture techniques null.
Biofilms might also play a role in the healthy gut, making it difficult to distinguish between pathogenic and healthy communities. [6]

Why do we need to eradicate biofilm

Biofilms interfere with detoxification and nutrient absorption, promote and protect co-infections, create arteriosclerotic plaque, and give cancer cells a place to hide. [7]

What’s more, biofilms can develop antibiotic resistance, rendering them difficult to eradicate.

Natural ways to eradicate biofilm

Conventional medicine often treats infections as if they were caused by planktonic bacteria, which as free-living bacteria that has a lower chance but can survive new environments. However, as so many bacteria are hidden in biofilms, giving them a secure way for them to reproduce and survive, this method of treatment can be ineffective.

Conventional therapies like antibiotics are inadequate for the treatment of biofilms and there is evidence that natural medicine therapies have comprehensive inhibitory effect on biofilms. [8]

These natural therapies can disrupt the biofilm in your gut and alleviate symptoms, as well as make testing for specific bacteria easier.

Heal your gut

When your gut microbiome is out of balance, you gut becomes an ideal place for biofilms to grow. Getting rid of bacteria and fungi can be the first step in creating an environment that’s less than ideal for biofilms. You can cut of their food supply and support your immune system by avoiding inflammatory foods such as gluten, dairy, corn, soy, eggs, grains, and nightshades. Eliminate toxic foods such as sugar, alcohol, trans fats, food additives, and preservatives. [9]

Find out more about healing your gut here. [10]

Quorum sensing inhibitors

Recent discoveries suggest that microorganisms can communicate with one another via cell signalling which causes the same types of cells to form colonies together. This mechanism is known as quorum sensing. Quorum sensing allows the microorganism to work as a group, changing and adapting to their environment. Therefore, to rid the body of some types of biofilms requires interfering with quorum sensing and breaking down the biofilms. [11]

There are many sources of quorum sensing inhibitors.

Here are just a few of the natural biofilm disruptors that have been proven to aid in the breaking down of biofilms:

N-acetylcysteine (NAC)

N-acetylcysteine (NAC), a precursor to the antioxidant glutathione, has been shown to be effective in inhibiting biofilm formation and in destroying developed biofilms.

Serrapeptase

Serrapeptase is considered a highly effective anti-inflammatory agent. It limits the ability of biofilm to form and can be very effective against antibiotic-resistant bacteria.

Alpha lipoic acid

Alpha-lipoic acid is an antioxidant that is made naturally in the body and is also found in foods.

Polysaccharide-digesting enzymes, including nattokinase and bromelain

These enzymes catalyse the breakdown of starch into sugars. Starch is a mixture of amylose and amylopectin polysaccharide polymers.

Lauricidin

Lauricidin, a natural surfactant (a surface-active agent) found in coconut oil helps inhibit the development of biofilms.

Curcumin

The active constituent of turmeric is known for its antibacterial, antifungal, antiviral, and antiparasitic properties. It’s now also recognised as an effective biofilm-disruptor, in addition to decreasing inflammation.

Apple cider vinegar

Apple cider vinegar contains acetic acid in addition to other acids, vitamins, and minerals. It is also shown to break down biofilms. When consuming apple cider vinegar, it’s recommended to use one to two tablespoons in a glass of water. [12]

Berberine

Berberine is an active constituent of several medicinal plants including Oregon grape and goldenseal, and has been clinically shown to exhibit antimicrobial, antiprotozoal, and anti-diarrhea; activity, acting as a natural pharmacokinetic.

Garlic

Garlic has antimicrobial properties against different types of bacteria, viruses and fungi. The organosulfur compounds present in garlic are responsible for its antimicrobial activity. Studies have shown garlic to be effective in disrupting biofilm.

Oregano

Oregano is especially helpful for getting rid of unwanted pathogens from the GI tract. It’s active property, carvacrol, has been shown to inhibit antibiotic resistant bacteria, viruses, parasites and fungi.

How we can help

Detecting biofilms is challenging but at Advanced Functional Medicine, our team of experts have access to the testing tools and treatment options not offered by conventional medical practitioners. With the ever-increasing difficulties that antimicrobial resistance presents, alternative therapies for eradicating biofilms are valuable solutions to these problems.

We commonly address biofilms in our treatments with patients when clearing pathogens and other bacteria’s from the body.

What are biofilms and are they harmful?