Joan Rothchild Hardin
Update to “Successful Holistic Treatment of Clostridium Difficile Gut Infection: Case Study” (2011)
I’ve learned a lot in the ten years since I had a Clostridium difficile gut infection and got rid of it using a protocol of probiotics and other nutritional supplements instead of antibiotics, which had led to my getting C. diff in the first place. The article I wrote about C. diff and my protocol, Successful Holistic Treatment of Clostridium Difficile Gut Infection: Case Study, was published in the Oriental Medicine Journal in 2011 and can also be found on the Peggy Lillis foundation website.
The main thing I’ve come to understand is that people who develop and maintain a robust gut microbiome don’t get C. diff – and are also protecting themselves from most of the other nasty health problems that can ail us – from skin conditions like acne and psoriasis to Crohn’s disease, multiple sclerosis, endometriosis, restless legs syndrome, rheumatoid arthritis, lupus, diabetes, Guillain-Barre syndrome, ankylosing spondylitis, most heart disease and some cancers.
Information about C. diff from the Centers for Disease Control and Prevention (CDC, 2020):
C. diff (also known as Clostridioides difficile or C. difficile) is a germ (bacterium) that causes severe diarrhea and colitis (an inflammation of the colon).
It’s estimated to cause almost half a million infections in the United States each year.
About 1 in 6 patients who get C. diff will get it again in the subsequent 2-8 weeks.
One in 11 people over age 65 diagnosed with a healthcare-associated C. diff infection die within one month.
Below is a compendium of responses to questions about my article that people have sent in.
Q. This article is from 10 years ago. I checked and found that Repleniss and Hyper Implante aren’t in production anymore. What probiotic supplements can I take instead of them in 2020? My doctor recommended Culturelle.
A. Culturelle is a nice start for repopulating your gut to force out the C. diff baddies but it’s not sufficient.
The main ingredient in Culturelle is Lactobacillus rhamnosus, which is one of the 5 probiotic bacteria mentioned in the following article excerpt as having been shown to be effective for preventing a C. diff infection: Choosing the best probiotic for C. diff. (on the Peggy Lillis Foundation website):
How do I know which probiotics can be used to prevent a C. difficile infection?
“Fortunately, there is over 35 years of research done in different countries with clinical studies and randomized controlled trials that have shown which probiotic strains are effective for different types of diseases. In 2020, the American Association of Gastroenterology recommends four probiotics to prevent C. difficile infections after antibiotic exposure, but five others types of probiotics were not found to prevent C. difficile infections. Only two of the probiotics had multiple trials to support this claim: Saccharomyces boulardii CNCM I-745 [Florastor®, Laboratories Biocodex] and a three-strain mixture of L. acidophilus CL1285 + L. casei LBC-80R + L. rhamnosus CLR2 [Bio-K+, Bio-K PLUS International].” (Peggy Lillis foundation, 2020)
But our guts need a wide variety of probiotics to boot out a C. diff over run and keep us healthy. I think a mix of probiotics called Probiotic Synergy (Designs for Health) would be a good substitute for Repleniss and Hyper Implante. If you have a candida overrun, you might not be able to tolerate the milk-based probiotics in it.
Then there’s Saccharomyces boulardii, a probiotic yeast. It’s excellent for helping get rid of C. diff. Dr Gabrielle Francis, my naturopath, warns that it and probiotics derived from milk can be problematic for people who have a Candida yeast overrun. So if you don’t need to avoid yeasts, be sure to add S. boulardii to your supplements list. The brand I like is Jarrow’s Saccharomyces boulardii + MOS. It’s also a lot cheaper than the Florastor mentioned above.
Here’s full info on S boulardii, including contraindications, on WebMD:
Saccharomyces Boulardii 250 Mg Capsule Antidiarrheal Formulations With Gut Flora Microorganisms S. boulardii has been known for decades to be effective against diarrhea from all causes. I always pack a bottle of it whenever I travel and take lots of it anytime I absolutely need to take an antibiotic.
Because S. boulardii is a probiotic YEAST, not a bacterium, it’s perfect for taking while taking a course of antibiotic since yeasts aren’t vulnerable to being killed off and this yeast will help keep your gut happily populated with probiotics. This is a peer reviewed scientific article about the benefits of S. boulardii. Look at the Abstract & then scroll down to ‘Table 2. Mechanisms of action of Saccharomyces boulardii in specific infections’ to read about how this amazing probiotic yeast combats C. diff: Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders
Then there’s GI-REVIVE. If I’d known about it ten years ago, I also would have added GI Revive to my protocol. Its principal ingredient is the amino acid l-glutamine, which is the main building block of the mucosal lining of the gut, where our probiotics live. See the question What probiotics do you take now to make sure you don’t get C. diff again? below for more information on how l-glutamine would have been so helpful.
Q. Where do you get the supplements you take?
A. Mostly online, from Amazon and VitaCost.
Q. What was the best dosing and timing of the different supplements you took?
A. I took those supplements in the dosages given in my article, all together, with meals. Since my article is a case study describing what I did, I can’t answer your question about ideal timing.
Q. How long into following your protocol did the diarrhea stop?
A. It was ten years ago that I had my battle with C. diff so I can’t tell you exactly when I felt entirely better. If I recall correctly, I started feeling somewhat better after maybe a month – but, although it had been strongly recommended early on, I didn’t start taking S. boulardii for quite a few months into my illness. I do recall that adding it to my supplements egime made a huge difference and I managed to vanquish the C. diff nasties much more quickly after that.
At that time, in 2010, everything I found online about C. diff talked only about taking antibiotics rather than restoring one’s seriously imbalanced gut microbiome with supplements. Peggy Lillis died from C. diff in April 2010 at the same time I first became ill with it, so her sons, Christian & Liam hadn’t yet started the Peggy Lillis Foundation, which has grown into a respected source of information about C. diff. All I knew then was that it made no sense to me take a heavy duty antibiotic as a treatment for an illness that had been caused by taking antibiotics in the first place. So it was just Dr Denice Hilty, my chiropractor who was my principal health care provider, Dr David Miller, an MD I knew from my local health food store, who was very knowledgeable about nutritional supplements and me working together to figure out how to treat me in a different way. We stumbled along with me as a willing guinea pig – and it worked!
And people have let me know in the years since I published my article in 2011 that it’s worked for them too.
Q. What time of day is it best to take BroccoMax and Allicidin, how much of each and in what order?
A. The dosages for Broccomax & Allicidin are in my article: * BroccoMax (Jarrow Formulas) a supplement made from broccoli seeds, which kills C. diﬃcile Dose: 2 capsules 2X/day * Quantum Allicidin Complex (Premier Research Labs), a supplement made from a wild garlic extract, which breaks open the bioﬁlms, mucopolysaccharide sacs C. diﬃcile forms to protect against being killed oﬀ Dose: 2 capsules 3X/day I increased the dose to 3 capsules 3X/day after three months. If I were following the protocol now, I’d start at the large dose right away. Q. How do BroccoMax and Allicidin kill C. diff?
A. The organic compound Sulforaphane Glucosinolate is the main ingredient in BroccoMax. A search for ‘Sulforaphane Glucosinolate & Vancomycin’ found this explanation of how this works: The antimicrobial effects of glucosinolates and their respective enzymatic hydrolysis products on bacteria isolated from the human intestinal tract The organic compound allicin (a component of garlic extract), is the main ingredient in Allicidin. Garlic and its component allicin are both known to destroy biofilms.
See these articles: Antimicrobial activity of natural products against Clostridium difficile in vitro and C-Diff Symptoms and Treatments.
Q. Will it help to take either BroccoMax or Allicidin alone or do they need to be taken together?
A. They need to be taken in combination:
*The organic compound allicin (derived from garlic) in Allicidin breaks open the biofilm cysts that C. diff bacteria form to hide safely in inside the colon walls.
*The organic compound sulforaphane glucosinolate in BroccoMax kills C. diff bacteria.
*So if you were to take BroccoMax without also taking Allicidin, you’d be leaving some C. diff bacteria hiding inside those cysts.
*And if you were to take Allicidin without also taking BroccoMax, you’d open the cysts and then have an even larger nasty population of C. diff bacteria inside your colon.
Q. Can I take BroccoMax and Allicidin while on Vancomycin?
A. I assume you can take both supplements while taking Vancomycin but don’t know for sure. As you know from my article, I declined taking an antibiotic when I discovered I had C. diff. Just didn’t make sense to me since it was antibiotics that had wiped out enough of the probiotics in my gut to allow the C. diff bacteria to colonize in there and make me sick.
Q. What probiotics do you take now to make sure you don’t get C. diff again?
A. These are the probiotics I take every day: * Complete Probiotic (Dr Mercola) 1 in the morning with breakfast * Complete Spore Restore (Dr Mercola) 1 in the morning with breakfast * Align 1 in the morning with breakfast * Lactobacillus Gasseri (Swanson) 1 in the morning with breakfast
Here’s info on the various probiotic strains in Mercola’s Complete Probiotics along with his explanation of why also taking Complete Spore Restore is important:
TAKE CONTROL OF YOUR GUT HEALTH WITH OUR AWARD-WINNING PROBIOTICS
This supplement is also very important because it contains the amino acid L-glutamine, the main building block of the mucosal lining of the gut where our probiotics live. This amino acid repairs and maintains the integrity of the gut lining , which is where our probiotics live. A healthy, intact gut lining also promotes over all health.
* GI-Revive (Designs for Health) 2 capsules with meals or the equivalent in powder form. (Start with 1 capsule/day , see how you tolerate it and gradually work up to the full dose.)
An article explaining why L-glutamine is so important for gut and overall health:
Glutamine: The Powerful Amino Acid for the Gut
Digestive enzymes are also very useful. I like: * Complete Digestion (Enzyme Science) 1 3X/day, with meals
Q. What about getting probiotics from foods?
A. Kefir is also a great source of milk-based probiotics. Get one that’s organic (if possible) & unsweetened -or buy some kefir grains and make your own using milk from pasture-fed cows. The fermentation process for making milk into kefir eats up 99% of the lactose in the milk, which is great in case you have a problem with dairy products. Here’s an article about kefir from my website.
Donna Schwenk’s website, CULTUREDFOODLIFE.COM, is a great source of information about the health benefits of kefir.
Also see 11 Probiotic Foods That Are Super Healthy and 14 Probiotic Foods for a Healthy Gut. Just remember if you’re eating pickles to add probiotics to your diet, they must be actually fermented in salt brine, not ‘pickled’ with vinegar. And of course, sea salt is a whole lot healthier than so called ‘table salt. Sea salt like pink Himalayan contains all the trace minerals our bodies need and which are found in sea water (our original home). In contrast, ‘table salt’ is heavily refined to remove all those trace minerals, which are then sold to companies a making nutritional supplements. And, by the way, it’s ‘table salt’ that raises blood pressure. Avoiding ‘table salt’ and eating sea salt can actually normalize blood pressure.
Raw milk cheeses are one of my favorite sources of probiotics from food. They’re delicious and, if you’re the sort of person who can feel the energy emanating from living things, you’ll feel the the life in them when your hand gets near them.
Q. Does kefir kill C. diff bacteria?
A. This is an interesting article on using kefir to stop recurring C. diff infections when antibiotics aren’t working:
A tasty solution to recurrent Clostridium difficile: Curing recurrent C. diff infections without fecal transplantation.
I would say the probiotics in kefir don’t KILL C. diff bacteria. I assume the probiotics help fill up the space in your gut so the C. diff bacteria don’t have the place to themselves to take over.
Q. I’ve read that Manuka honey kills MRSA. Does it also kill C. diff bacteria?
A. Manuka honey, from New Zealand and Australia, has amazing therapeutic qualities. And it tastes great too.
Yes, a high therapeutic grade of manuka honey does kill MRSA, aids in wound healing from burns and also kills C. diff biofilms.
This is relevant because C. diff also forms biofilm cysts in the lining of the colon where the bacteria hide out when they detect the presence of antibiotics in the gut. Then they burst out & repopulate the gut, which now has even fewer probiotic bacteria living in it, when the antibiotics course is over. This clever maneuver on the part of C. diff bacteria explain why so many people get what doctors think of as ‘re-infections’ but are actually just a continuation of the original infection.
The therapeutic grade of manuka honey used in this study was UMF 26+.
The Inhibitory Effects Demonstrated by Manuka Honey on Biofilms: How Manuka Honey May Soon Replace Conventional Antibiotic Therapy
From the article:
“With C. difficile contributing to 30-50% of all nosocomial infections, it is pertinent to determine and implement effective treatment methods in order to combat this species of bacteria (Giles, & Labeij, 2017). Currently, fecal microbiota transplantation (FMT) is the most widely accepted and implemented treatment method. Giles and Labeij (2017) cite the use of commercially available Manuka honey with UMF 26+ with a patient with persistent C. difficile infection. After treatment with two honey lavages a week apart, a sample removed from the patient’s colon did not detect C. difficile (Giles, & Labeij, 2017). This discovery provides a promising alternative for the treatment of C. difficile infections.”
“Anti-Biofilm Activity in Manuka Honey in Combination with Antibiotics Manuka honey has been proven to inhibit in-vitro antibiofilm experiments. More specifically, Gentamicin and Manuka honey produced an additive interaction against P. aeruginosa biofilms and a synergistic interaction with vancomycin against S. aureus biofilms (Campeau & Patel, 2014). When Manuka honey dressings were utilized in conjunction with oxacillin, tetracycline, imipenem, and mupirocim; a synergistic effect was achieved against MRSA (Carter, et, al., 2016). The findings suggested that the combined therapeutic intervention of
Manuka honey wound dressings and antimicrobials could lower the dosage of antimicrobial medications required to inhibit the biofilm as well as prevent the development of resistance.
“Manuka honey’s bactericidal action is associated with non-peroxide antibacterial activity (NPABA). In-vitro isolates with multi-drug resistant phenotypes have not demonstrated any reduction in their susceptibility nor generated any honey-resistant strains to Manuka honey when administered at inhibitory levels under normal laboratory conditions (Carter, et, al., 2016).
“While bactericidal effects were seen in both planktonic cultures and biofilms, a higher concentration of Manuka honey was required to inhibit sessile bacteria, compared to its counterpart, free-living bacteria (Hammond, et. al., 2014). Test strains of well-known pathogenic bacteria were inhibited at lower concentrations in a liquid medium compared to on agar well diffusion plates (Hammond, et. al., 2014). This finding may be attributed to the ability of the components of Manuka honey to diffuse more readily and uniformly in a liquid medium due to the osmotic effects.”
This article explains the therapeutic grading system used for manuka honey. It’s a little confusing but the rule is – the higher the grade, the higher the jar of honey’s therapeutic value :
The Manuka Honey Grading Systems – How to Get Real Manuka Honey
Q. Have you had a recurrence of C. diff since following the protocol in your article?
A. No. I chose not to take any antibiotics 10 years ago and instead focused on building up a strong level of probiotics in my gut so the C. diff bacteria in there would get forced out and then wouldn’t have enough space to colonize my gut ever again.
Q. Why did you decide not to take an antibiotic to treat your C. diff infection?
A. When I got the C. diff diagnosis, I learned that it had been frequent courses of antibiotics that had ruined my gut microbiome by killing off enough of the good (probiotic) bacteria had been living in there until there was ample space for bad (pathogenic) bacteria like C. diff to take it over as their own. Anti-biotics kill good bacteria right along with the bad ones.
Also, I quickly learned that a large percentage of people who treat their C. diff infections with heavy duty antibiotics like Vancomycin or Metronidazole find it comes back again – often with a vengeance since the antibiotic has now killed off even more of the good bacteria in their guts, allowing even more C. diff bacteria to grow in there.
That’s because C. diff bacteria create biofilm cysts that they can hide in while they detect antibiotic inside the gut. These cysts borrow into the walls of the colon & burst open when they detect that the antibiotic has finally cleared the gut. When the gut now has another round of C. diff bacteria in it but even fewer probiotics to limit its ability to reproduce, the human host becomes even sicker.
I’ve been contacted by C. diff sufferers whose doctors have put them on multiple, repeated courses of Vancomycin, Metronidazole or one of the other heavy duty antibiotics known to kill C. diff. every time they get sick again, apparently not understanding the mechanism C. diff uses to keep its hold on their territory inside the gut – or maybe just not knowing there’s a non-pharmaceutical way to get rid of C. diff and keep it from returning.
It seems to me that a recurrence of C. diff following a course of antibiotics doesn’t mean the person has contracted the infection again but rather that the C. diff bacteria formed biofilm cysts in reaction to detecting an antibiotic in the gut and burrowed into the wall of the colon until the coast was clear. Then the cysts opened, releasing another army of C. diff bacteria into the colon – where they now encounter a seriously reduced army of good bacteria to fight them off. And this process repeats itself each time an antibiotic is given.
Many people who’ve contacted me have taken up to 12 courses of antibiotics, kept relapsing and becoming significantly sicker each time, lost a huge amount of weight (some have become so weak they don’t have the strength to get out of bed and can no longer take care of their children or earn any money) and know they’re going to die unless another way to treat them is tried.
Continuing to give people repeated doses of heavy duty antibiotics reminds me of American soldiers during the Vietnam War who claimed with all seriousness, “We had to destroy the village in order to save it”. Ie, allied commanders gave the order to bomb and shell the village regardless of civilian casualties – to rout the Vietcong. Another reason I opted not to take an antibiotic is that a serious problem has developed world wide from the over use of antibiotics: Many bacterial pathogens have mutated to become ANTIBIOTIC RESISTANT.
BTW, factory farmed animals are routinely given antibiotics in their feed to keep them from becoming ill in the overcrowded, unsanitary conditions they live in so we’re also unknowingly getting doses of antibiotics in our food unless we avoid factory farmed meats & fish. But that’s another whole topic you can look into as you come to understand how you got this C. diff infection & how to avoid getting another one.
Q. Is there research showing the effectiveness of any other probiotic against C. diff?
A. Here’s an article about the effectiveness of Lactobacillus reuteri against C. diff:
Probiotic Proves Deadly Against Clostridium Difficile
L. reuteri strains are isolated from dairy and meat products and also from animal sources. L. reuteri is a probiotic culture and a member of the NSLAB population in several cheese varieties (e.g., Cheddar, Grana Padano, Gruyère, Idiazabal, Parmigiano Reggiano, Roncal, and Toma). (Science Direct, 2020)
Q. Can you explain why it’s so important to keep my gut lining strong?
A. See my article:
The Gut's Mucosal Lining & Leaky Gut
C.diff can reproduce by creating hardy, long-lasting spores. Spores are difficult to kill on surfaces. Spores can reside in the gut and evade antibiotic treatment.
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Hardin, J.R.(2013). Kefir. See: https://allergiesandyourgut.com/superimmunity/kefir/
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Tarantino, O. 2019. 14 Probiotic Foods for a Healthy Gut. See: https://www.eatthis.com/best-probiotic-foods/
UHN Staff. (2020). C-Diff Symptoms and Treatments. See: https://universityhealthnews.com/daily/digestive-health/c-diff-symptoms-and-treatments/
WebMD. (2020). Saccharomyces Boulardii 250 Mg Capsule Antidiarrheal Formulations With Gut Flora Microorganisms. See: https://www.webmd.com/drugs/2/drug-21589/saccharomyces-boulardii-oral/details
Zhai, H. et al. (2014). Lavage with Allicin in Combination with Vancomycin Inhibits Biofilm Formation by Staphylococcus epidermidis in a Rabbit Model of Prosthetic Joint Infection. PLOS One. See: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4099135/
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