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Very interesting reading regarding strep and gut bugs. Could negative swabs be explained by this, with ongoing elevations in titers?





I am writing this to clarify information that is circulating regarding the

biofilm theory that I presented to the Defeat Autism Now Think Tank last week.


True Health Medical Center:

"Potential Implication of Biofilm Formation in Patients with ASD",

Presented to the Defeat Autism Now Think Tank, Oct. 11, 2007


I presented a theory about the implications of biofilm production by resistant

strains of bacteria/fungus in our ASD patients who have persistent dysbiosis.

The literature search that I conducted with the help of Teresa Conrick, MS and

Sonja Hintz, RN was quite convincing. The abnormal production of biofilm by

resistant strains of microorganisms may be a possible etiology of why many of

our patients who do not have positive stool cultures for yeast or pathogenic

bacteria do well when placed on antifungals and antibiotics, yet relapse when

they stop. The biofilm produced by these resistant organisms can only be seen

by electron microscopy and makes it difficult to culture these bugs. This theory

might also explain subtypes of our ASD subpopulation who have abnormal

behaviors, such as head banging or agitation, that seem to be gut pain related,

yet again have negative studies. The third subset that this seems relevant for

is the group of children that have recurrent strep

infections, OCD, perseverative, or repetitive behaviors who get worse in the

spring and fall, yet may not test positive for strep.


Why do so many of our ASD kids have persistent dysbiosis? This is my theory.

We all know that the quality of our air, water and food is not ideal and

contains numerous toxins and pollutants. Our children have a genetic

susceptibility in their ability to handle this toxic burden. Research shows us

that resistant organisms tend to grow in toxic, hostile environments, and after

numerous rounds of antibiotics. They maintain their viability by producing a

polysaccharide matrix that protects them from the hostile environment in which

they are trying to survive. This extracellular matrix is called biofilm. Our

normal flora also produce a natural biofilm, but resistant organisms produce

their own biofilm which then takes over, preventing the normal flora from

flourishing. Experiments done in vitro show that this polysaccharide matrix is

negatively charged, and that it is held together by positively charged ions such

as Ca, Mg, and Fe. Iron seems to play a big role in how

these bacteria evade the immune system. Further work on VRSA/MRSA and

pseudomonas biofilms in vitro indicate that this biofilm may be penetrated by

using a combination of EDTA and an antibiotic; the studies used Vancomycin for

Staph and Gentamicin for Pseudomonas.


The protocol that my staff and I developed was presented in its infancy at the

October 2007 Think Tank. The Defeat Autism Now Think Tank is usually a forum

where ideas are presented for discussion and further research. This protocol

was not discussed in great detail (15 minutes was allotted for this discussion),

and it was not meant for wide distribution at this time. However, Dr.

Bradstreet presented it in his talk on New Advancements and clinicians and

patients from all over the world are now asking for our protocol.


However, let me start with a few caveats. First of all, this is brand new.

We have used this approach on about 60 patients. The first two were Teresa's

and Sonja's children - one with ASD/self injurious behavior and one with

colitis, no ASD. Both initial patients are doing well. However, this treatment

has to be individualized for each patient's unique constitution and ability to

handle both die-off and detox type reactions. From our other patients we are

seeing a variety of responses from decreased hyperactivity and stimming, to

increased agitation, to no response. Of course we may have a few bumps along our

journey to recovery. The big bumps with this approach are related to awakening

the immune system to these organisms which it has not been recognizing. The

body finally sees the bacteria or the candida that has been there creating other

types of havoc all along. Acutely, patients may experience vomiting, diarrhea,

high temps. Rashes may appear, especially if

the die off is sudden. The other theoretical issue is that the biofilm may be

holding on to toxic metals such as aluminum and lead. As this toxic biofilm

degrades heavy metals may be released into the gastrointestinal tract for

excretion. Our protocol was developed to address this possibility.


I urge all of you to have patience and wait for us to gather more data on this

approach so that you are presented with the safest, most effective protocol.

Remember, your doctor should implement this approach gradually with the unique

needs of your child in mind. Because of the possibility for negative side

effects, and the need to closely monitor the patients, and the possible use of

pharmaceuticals, this treatment plan should be implemented only with the help of

your physician.




True Health Gut Biofilm Protocol™


Step One: Lysis and Detachment of the Polysaccharide Matrix

(empty stomach, 30-60 min prior to Step 2)

-Use of specific enzymes. (these are being refined and developed, as the

enzymes we have available at this moment are not ideal)

-Use of a chelator that can grab hold of minerals in the Matrix. (if not

implemented appropriately this may cause mineral depletion in the body - do not

attempt chelation without proper medical supervision)


Step Two: Target the Microbe

- Consider using antibiotics, herbals, or homeopathics. (our office has had

extensive experience with all three modalities, and have found that the choice

"depends upon the kid". We are also researching a fourth modality that looks

quite promising for eradicating these pesty organisms.


Step Three: Clean Up

(This is the most crucial of all the steps. DO NOT SKIP!!! Give 1-2 hrs

after Step 2 if possible or at night)

-Here we use anything that can bind up the matrix (mucus), by products of die

off, and potential metals in the gut.

Products include activated charcoal, alginate, clays, algaes, zeolites,.... we

like pectin the best. Sometimes we use all of the above.


Other important factors

-Probiotics, of course.

-Anti-inflammatory agents such as EFA's, antioxidants, curcumin...

-Natural fermented foods such as kefir, kombucha...

-Healthful, non toxic foods (hormone- free, antibiotic-free, organic)


This is a short-term treatment plan, we are using it for about 2-3 months.


This protocol is still being developed and is not fully defined. We have only

been using this for about 6 months in a specific subgroup of our patients.

Remember, our ultimate goal is to restore the normal flora and the normal

biofilm. This takes time and the process is slow. It took years for some our

patients to reach this point, it may take time to reverse.


With hope for a better future for our kids and grandkids,


Dr. Anju Usman

Medical Director

True Health Medical Center

603 E. Diehl Rd. Suite 135

Naperville, Illinois


™True Health Medical Center, June 2007


“…the autoimmune process can be arrested if the interplay between genes and

environmental triggers is prevented by re-establishing intestinal barrier


Mechanisms of Disease: the role of intestinal barrier function in the

pathogenesis of gastrointestinal autoimmune disease. (Fasano, 2005)

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  • 1 month later...

Thanks, Kim. I found this article you copied by Dr. Usman very interesting. I am beginning to wonder about gut microorganisms playing a huge role in this myself. I just read a really good article about how gut dysbiosis can CAUSE multiple allergies. I know many, not all of us are dealing with kids that have a laundry list of allergies. We don't have a genetic connection to TS in our family. I found the following link an interesting take on how our modern world can contribute to gut imbalance.




Chemar, You posted a while back about candida diets-- and recommended a book? I really think I need to bone-up a little more on this subject. I read an informal survey on another forum asking mothers (with kids suffering multiple allergies) how many were on antibiotics while pregnant with their afflicted child. The response was overwhelmingly, yes. I was, twice. For my second child I was not, and he seems to be 'healthy as a horse'.


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Chemar, You posted a while back about candida diets-- and recommended a book? I really think I need to bone-up a little more on this subject.



it is called The Yeast Syndrome by Walker & Trowbridge

($7.99 at Amazon and also available at bookstores.)

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  • 2 weeks later...



I think there is a study listed on the right side reguarding candida and biofilm too. I know what you mean about suspicion of gut bugs.


Here are a few more studies regarding biofilm. The first one is quite interesting regarding increased glucose concentration resulting in increased biofilm. The last sentence about "reduce virulence factor expression," I take to mean that they didn't find things they would normally see elevated because of the biofilm, not that the strep is less virulent? Would like to find the complete study, if I just had more time!


The nutritional requirements for biofilm formation by Group A streptococcus




Josephine Shera, Kadaba S. Sriprakash and David J. McMillan,

Department or Bacterial Pathogenesis. Queensland Institute of Medical Research, PO Royal Brisbane Hospital Qld. 4029. Australia


Available online 20 April 2006.



Using a crystal violet assay, we tested the ability of 84 group A streptococcal (GAS) strains representing more than 50 different emm-types to form biofilms. Our data demonstrate that almost all strains under investigation (83 of 84) were able to form biofilms to some degree. Biofilm forming capacity was in general conserved among isolates of the same emm-type. Biofilm formation was not altered by carbon dioxide or sucrose. However, increased glucose concentration resulted in increased biofilm formation. As growth in the presence of glucose has also been reported to reduce virulence factor expression, we hypothesise that the biofilm mode of growth may be associated with evasion of host immune responses.



There is some interesting info contained in the studies listed below this one too




Mucosal Biofilm Formation on Middle-Ear Mucosa in the Chinchilla Model of Otitis Media

Garth D. Ehrlich, PhD; Richard Veeh, PhD; Xue Wang, MD; J. William Costerton, PhD; Jay D. Hayes; Fen Ze Hu, MS; Bernie J. Daigle; Miles D. Ehrlich; J. Christopher Post, MD,PhD

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