Updated on December 23, 2018

Step 3: MARCoNS

Staph in Biofilm

Clearing a nasty staph infection called MARCoNS deep within the nasal cavity is the third step in Dr. Shoemaker’s protocol. For those for whom mold is the issue, the first step is living and working in a relatively mold free place. The second step regardless of whether you’re suffering from mold, Lyme, algae, or other biotoxins is to take Binders.

MARCoNS Overview

MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staphylococci) is an antibiotic resistant staph infection that resides deep in the nose of 80% of people with low MSH (Melanocyte-Stimulating Hormone 35-81 pg/ml using Lab Corp only #010421) – folks suffering from Biotoxin Illness and other chronic inflammatory illnesses – see Dr. Ritchie Shoemaker’s work. This percentage increases when the person has also been treated with antibiotics for a month or more. Once they’ve taken up residence, MARCoNS will further lower MSH (MARCoNS make hemolysins that cleave MSH rendering it useless), increase cytokines, and lower T-reg cells resulting in Chronic Fatigue symptoms of body aches and debilitating exhaustion.

As MSH is further lowered by MARCoNS, fatigue and chronic pain due to reduced endorphins and increased cytokines will ensue. In addition, hormone imbalances, mood swings, leaky gut, alternating constipation and diarrhea, lower melatonin (poor sleep), and low ADH (Antidiuretic Hormone) are all the result of too low MSH. When MSH falls too low, the body initially raises ACTH (Adrenocorticotropic Hormone) and Cortisol in response to the increased stress thereby keeping the person functional – although the candle is burning at both ends.

However, over time the body loses the ability to compensate resulting in ACTH and Cortisol values that fall below normal level – adrenal fatigue sets in. Related to ADH, an imbalance between lowered ADH and plasma Osmolality (a measure of body hydration) results in the person being unable to hold water (frequent urination) and may lead to frequent static shocks due to the higher than normal salt levels on the skin – along with lower back pain, fungal overgrowth, depression, allergies, obesity, and other symptoms associated with chronic dehydration. Incidentally, C4a and TGF-beta1 are typically quite high in people with Biotoxin Illness, also called Chronic Inflammatory Response Syndrome (CIRS). In some, MARCoNS can suppress these two CIRS markers.

MARCoNS do not necessarily cause symptoms like a runny nose, sinusitis or facial pain. Interestingly, Dr. Shoemaker did some work wherein the culture of the nose and the socket of a pulled tooth frequently showed the same MARCoNS. Personally, I feel that MARCoNS infect the entire nasal and sinus passageways along with the jaw bones. As a result, they are incredibly difficult to kill. Experientially, when I have MARCoNS, I’m more irritable, don’t sleep as well, wake more frequently, have more nightmares, experience thick post-nasal drainage, have a dull ache where an upper tooth was removed along with more frequent blockage on one side or another of my nose, and can feel a sort of nagging irritation deep in my nasal passageway.

Additionally, my personal belief is that the lowered melatonin levels are due to lower serotonin levels since melatonin is made in the body by converting serotonin to melatonin. We know there is major gut dysbiosis and this results in lower serotonin. Lower serotonin alone produces a whole host of symptoms ranging from afternoon cravings, depression, panic attacks, suicidal thoughts, GI problems, and so on. Dr. Mary Ackerley comments on lowered serotonin.

By the way, the noses of dogs are frequently a source of MARCoNS (cats are safe). There have been cases where individuals that allowed their dog into bed were not able to clear MARCoNS until the dog was treated. Vets can test and treat dogs using the same protocol. No more “kisses” from your pet. Along the same line, if you’re being exposed to higher amounts of mold, clearing MARCoNS can also be problematic.

Dr. Ritchie Shoemaker – MARCoNS FAQ
Informative MARCoNS Discussion

Note: Technical information is from notes I made when studying Dr. Shoemaker’s work. Also, I had to laugh when Dr. Shoemaker described MARCoNS patients as “Mood swings are common; these are the most difficult patients you and your staff will ever treat. They can drive you crazy if you let them. Follow their line of thinking, but cut it off when the logic starts to fail. Don’t let them get away with assumptions and wacko medicine, they will try.”
It’s true, it was a full time job many days to just maintain my basic sanity – thank goodness for my logical mathematics background. Still, I’m guessing he’d say that I haven’t been able to avoid some “wacko medicine”. He’s still my hero 🙂

Dr. Yoshi
Dr. Yoshi Rahm – Oasis Family Medicine

MARCoNS Testing

  • MARCoNS Swab KitMARCoNS are very slow growing. Consequently, the standard nasal swab that’s cultured for two days by Quest or Lab Corps will not detect these organisms. If your physician doesn’t do a deep swab and send it to Diagnostic Laboratory Medicine, expect the results to come back negative.
  • Dr. Shoemaker insists that the API STAPH technique along with the kirby bauer antibiograma for identifying difference between similar staph species be used. Make sure to use the standard red-topped Copan swab (not alginate swabs).
  • You can call CLIA certified MicrobiologyDX (formerly Diagnostic Laboratory Medicine) in Bedford Massachusetts (781-276-4956) and simply ask for them to mail a test kit for MARCoNS to your house. They also do fungal nasal cultures – see Fungal Colonization below.
    • They will ask for your physician’s name, address, phone, and fax number so have this information ready.Nasal Anatomy - Swab Insertion
    • The swab can either be done at home or by your physician.
    • Lab results will be faxed to your physician.
    • Talk to the lab about billing. In the past, they billed my physician who then billed me but you may be able to have billing sent directly to you. The cost is $50 for a negative outcome and $85 for a positive culture showing what antibiotics are effective.
    • Make sure to take the specimen past the turbinates to the nasophyranx where the swab should be moved up and down for 5 seconds on one side only. The depth of insertion is usually about 3 to 4 inches.Note: Folks with a more highly arched palette (roof of the mouth) tend to have more difficulty getting past the turbinates. To ensure accurate results, the swab needs to go deep enough – see video.

MARCoNS Test Results

MARCoNS Test - Large Amount
MARCoNS Test - Small Amount MARCoNS Test - None

  • It takes a couple of weeks to get results.
  • If your test results states “STAPH COAG NEGATIVE” as being present with two or more antibiotics, in the list of a dozen or so antibiotics, showing up as either “R” (resistant) or “I” (intermediate), then you’ve got MARCoNS. By the way, “S” means susceptible.
  • Dr. Shoemaker has commented that the methodology for estimating amounts is less than perfect. Given this, it doesn’t matter if you’ve got “SMALL” or “LARGE” amounts of Staph Coag Neg.
  • It doesn’t matter if the Staph Coag Neg is listed as “METHICILLIN RESISTANT” or not. Although, those with a Methicillin Resistant strain tend to HERX more often with BEG spray.
  • Update January 21, 2015
    After comments from Readers below and pouring over Dr. Shoemaker’s FAQs, it appears that the real concern is whether Coagulase Negative Staphylococci are present and if they are biofilm formers. It seems that testing for antibiotic resistance was just an easy way to determine if the Coagulase Negative Staphylococci was protected by a biofilm (it’s the biofilms that makes it possible for the staph to resist antibiotics). In the instances where Coagulase Negative Staphylococci is present but is only resistant to one or no antibiotics, Dr. Shoemaker has worked with a lab that does “biofilm production assays” of nasal cultures looking for biofilm forming coagulase negative staph. Unfortunately, this lab only does this assay in lots of 96 at a cost of $100 each. As such, the ordering Physician has to have a significant CIRS patient base. Given these limits, this testing is essentially unavailable.

    It’s all about Coagulase Negative Staphylococci with a protective biofilm. If Coagulase Negative Staphylococci are present but are not protected by a biofilm, Dr. Shoemaker does not recommend treatment. Likewise, for those with other types of staph, this does not appear to be an issue in relation to Biotoxin Illness. Although, from the benefit I’ve seen in treating MARCoNS and then nasal fungi, I would definitely do some digging and determine if the staph in question was related to health issues. If it was, I’d determine how best to treat it – BEG spray may not be the best choice.

    So the question becomes what to do if you’ve got Coagulase Negative Staphylococci but they’re not MARCoNS. One option would be to do a trial of BEG spray as we know some with MARCoNS, and particularly with Methicillin Resistant MARCoNS, will HERX usually in the first week along with having VCS fall in column E followed by column D. If a HERX occurs, this is suggestive of biofilm forming staph. On the other hand, not much can be concluded if no HERX occurs.

    Personally, if I had Coagulase Negative Staphylococci regardless of the amount, Methicillin Resistance, or the number of antibiotics the staph was resistant to, I’d most likely take BEG spray or try treating with one of the alternative approaches. We know MARCoNS bring down the hormone MSH and MSH is so critical. Regardless of how you treat, you can always do another swab to confirm whatever method you chose was effective.
    Update End

MARCoNS Treatment

  • Dr. Shoemaker’s Approach
    To ensure the best chance at knocking out MARCoNS, you need to complete the first two steps of Dr. Shoemaker’s protocol first – going after MARCoNS is step three. Step one it to make sure your home and work environments are mold free. Step two is to be on cholestyramine for at least one month before treating MARCoNS. Cholestyramine is the binder that globs onto the mold toxins that are put into your gut by the liver before they get a chance to slip through the intestinal wall and get back into the bloodstream where they can wreck more havoc.
  • MARCoNS protect themselves from antibiotics and other treatment methods by forming a protective biofilm around themselves. Consequently, simply throwing the usual antibiotics at them won’t work – it just makes them stronger 😉
  • In the past, Dr. Shoemaker treated MARCoNS with two 300mg pills of Rifampin antibiotic along with one BEG spray in each nostril three times daily. Rifampin was taken for one month and BEG spray for two months.
  • It’s been observed that Rifampin (a somewhat difficult antibiotic) is unnecessary. The new protocol Dr. Shoemaker’s recommends is to spray twice into each nostril three times daily with no additional antibiotics for six weeks – blow your nose before and aim the tip more toward the back of your head (with Rifampin spray one time only in each nostril). At 0.1mL per spray, this works out to 1.2mL per day and 50.4mL over the course of six weeks. The standard 60mL spray bottle is good for 50 days – more than enough.
  • Note: Although not technically part of Dr. Shoemaker’s protocol, xylitol nasal spray that can be purchased as Xlear helps with breaking up biofilms that protect the infection, maximizes sinus flow, and reduces BEG side-effects. To reduce “burning” from BEG spray, use Xlear xylitol nasal spray 3-4 times a day for one week before starting BEG spray. Once started on BEG spray, alternate use of Xlear and BEG spray 3 times daily. Begin by administering BEG spray. Wait 2 hours, then use Xlear. Wait another two hours, then use BEG spray, and so on. Besides being a biofilm buster and flushing the sinuses, Xlear has some anti-bacterial properties, keeps the sinuses hydrated reducing stinging, and improves the success rate of BEG spray.
  • Before beginning BEG spray, it’s important to have baseline testing of VCS and MMP9. This is important in the event that BEG spray causes a detox reaction. This happens more often for those with a Methicillin Resistant variant and usually within the first week. Intensificatoin of symptoms can also occur in those with especially high MMP9.If symptoms worsen and VCS falls first in column E followed by column D, then you must stop treatment and recheck MMP9. If MMP9 is rising and VCS is falling in the face of a HERX, this is indicative of active Lyme. Non-Lymies will have stable MMP9.
  • When MARCoNS are present, the benefits from taking Cholestyramine (CSM) can be muted. In addition, the inflammatory labs for C4a and TGF-Beta 1 that are normally high in someone with Biotoxin Illness may be near normal when MARCoNS are heavy.
  • The BEG spray consists of Bactroban (Mupriocin) 0.2%, EDTA (Edetate Disodium) 1%, and Gentamicin 3%. The EDTA knocks out the biofilm that MARCoNs use to protect themselves (biofilms are a slimy coating that the staph bacteria hide under) so the two antibiotics can clear the infection. BEG spray is available from Hopkinton Drug Inc. in Massachusetts, Woodland Hills Pharmacy in California, and other compounding pharmacies. Note: Some physician’s are even having good results with one spray in each nostril three times daily.
  • Update August 2, 2016
    Caleb from Toxic Mould Support Australia wrote to me with some additional information about where to get BEG compiled by Rebecca from Denver Area Mold Illness Information and Support Group and Toxic Mold, CIRS and Lyme Disease Support Group. Rebecca mentions Mixtures, Remedies, Montana Compounding, and Acacia pharmacies as additional sources. Thanks Rebecca and Caleb!
    Update End

    Update February 24, 2016
    I recently heard that Hopkinton Drug only uses 0.025% Gentamicin in their BEG spray. Based upon the ringing I got in my ears when I used BEG spray, this seems like a good change. Also, per the recent presentation by Dr. Robin Thomson ND on Saturday at the 2015 State Of The Art In Mold, Wet Buildings, & CIRS Conference, it’s recommended that 15% Mucoadhesive Polymer Gel (MAPG) be added to the spray. MAPG is sticky. It helps the antibiotics stay in the nasal cavity longer and slows their breakdown by the body’s enzymes. Based upon Dr. Thomson’s n=6 data, if you look at the first rounds of BEG treatment only, then there is a 58% success rate with BEG alone and 100% success using BEG and MAPG. MAPG is only available to Compounding Pharmacies that are PCCA members.
    Update End

    Gentamicin Side Effects: Gentamicin can cause serious kidney problems and nerve damage, resulting in permanent hearing loss (including deafness or decreased hearing) and balance problems. The risk is increased if you are older, already have kidney disease, or if you have a severe loss of body water (dehydration). Tell your doctor immediately if you notice ringing/roaring sounds in the ears, hearing loss, dizziness, or an unusual decrease in the amount of your urine.

    Bactroban Side Effects: Bactroban (Mupirocin) is typically used in a topical ointment and may cause burning, stinging, itching, swelling, pain, headache or nausea at first as your body adjusts to it. In rare cases it may cause abdominal pain, dizziness, secondary wound infection, or sores on mouth and on lips.

    Update March 30, 2015
    Gentamicin is considered to be Ototoxic (can cause damage to both inner ears resulting in “Bilateral Vestibulopathy” – vision, hearing, and motor coordination problems). It is reported that Dr. Shoemaker has had success treating MARCoNS just using Bactroban and EDTA (BE spray). Hopkinton drug can formulate BE spray or spray with another antibiotic besides Gentamicin. For example, BEC spray (Clindamycin) is available. Antibiotics should be selected from the list of Susceptible (S) antibiotics on the MARCoNS report.
    Update End

    Update June 20, 2015
    It has come to my attention that while Gentamicin is considered to be Ototoxic and may be absorbed systemically when used as a nasal spray, the risks are quite small. By far, if folks do have trouble with BEG spray, it’s from nasal irritation. Using Xlear nasal spray can help sooth irritation with the added benefit of busting biofilms. Much less common is fatigue along with body aches and pains. If you do HERX, see the notes above about monitoring MMP9 and VCS in relation to Lyme.

    So while I personally did experience some increase in tinnitus and intense fatigue and body aches, this is not common. The amount of Gentamicin used in BEG spray is a tiny fraction of the amount used in IV treatments that have resulted in ear damage. Does this mean you should ignore your body if you’re HERXing or your ears start to ring? Absolutely not. If you HERX and MMP9 along with VCS are OK, then talk with your doctor about backing down on the application rate until symptoms abate. If tinnitus is an issue, personally I’d ask for a spray without Gentamicin simply because my tinnitus was so bad that it was just really important that I felt like I was doing everything I could to make sure I wasn’t making it worse.

    Recently, I’ve been sitting in on phone consultations between Dr. Ackerley and my sister. Yippee, my sister is finally taking CIRS seriously! Dr. Ackerley is wonderful and sort of what you’d expect from a shrink that also treats CIRS – level headed, pragmatic, and warm hearted in a way that only a shrink that is skilled in relating to others on an emotional level can be. Since my sister lets her pet dog, Casey, get up on her bed, we discussed testing Casey for MARCoNS. Dr. Ackerley mentioned that she’s yet to see a dog come back positive for MARCoNS and only suggests testing pet dogs in cases where patients become re-infected with MARCoNS. She did point out that human bed partners are much more likely to be carriers. In hearing this, I went out and ordered a test kit for my loving wife. We don’t need to be passing those bugs back an forth!

    Above all, remember to take deep breaths through out the entire process of healing from CIRS. For many, it’s a bumpy road. However, with perseverance, diligence, and loving attention to your Being, it leads to renewed vitality along with a deeper appreciation of what it means to be alive. You can do it!
    Update End

    Over the last four years, I’ve taken two courses of BEG spray – got re-infected after the initial treatment. I herxed mildly (flu symptoms) about three days after starting the spray and it lasted a few days. The spray did sting a bit at first (keep in the refrigerator to reduce stinging) and my nose was very runny the entire time – the result of the biofilm breaking down. Also, there was a slight increase in the ringing in my ears during treatment and near the end of the six weeks I was hit with a wall of super intense joint and muscle pain. I attributed the pain to toxins released by an excess of “bad” microbes (excess yeast and fungi) resulting from the killing off bacteria in my gut with the antibiotics.

    I took high dose liposomal vitamin C and started phase 2 of Jini Patel Thompson’s protocol in “Listen to Your Gut” that consists in part in taking 10 drops of wild oregano oil in the morning to knock out the “bad guys” and Natren probiotics in the afternoon and evening to repopulate with the “good guys”. This knocked out the pain in 24 hours. Amazing. If I ever need to knock out MARCoNS in the future, I’m going to take probiotics 2 hours after every BEG nasal spray and then continue them afterwards to keep my gut flora in better balance.

    For an additional point of reference, a family member that has been sick for decades from Biotoxin Illness with large amounts of MARCoNS staph had severe headaches, fatigue, and body aches along with puffy eyes, increased stuffy nose, and an ear ache when treating with BEG spray. It was bad enough that the spray was stopped for a few days and then restarted to allow for some symptom relief. Unfortunately, even at lower doses, she couldn’t continue because the fatigue would have prevented her from being able to care for an even sicker friend 🙁 I believe part of this strong reaction was due to the fact that I could not get this family member to take cholestyramine for a month prior to using BEG spray as is dictated in Dr. Shoemaker’s protocol even though Dr. Shoemaker does say on rare occasions he would treat MARCoNS before CSM – when CSM was poorly tolerated.

    Jini Patel Thompson “Listen To Your Gut”

  • Dave Asprey’s Approach
    In a phone consultation with Dave Asprey, Dave indicated he’d successfully treated MARCoNS with a combination of nasal washes and spray (no BEG spray). Initially when his sinuses were really bad, he did nasal rinses six times a day. Later, Dave alternated daily between using Sovereign Silver twice daily and Lugol’s Iodine twice daily for a few months.
    • Caution!
      A small percentage of people are hypersensitive to iodine. At a minimum, apply iodine to a small test patch of skin before using iodine nasally. If you decide to use iodine, consider supplementing with selenium 200-400mcg daily in order to protect against Hashimotos.

    • Mix Sovereign Silver and Xlear 50/50 in a nasal spray bottle and use at least twice during the course of the day.
    • In a bowl of water with “salt” added to temper the salinity (make to same taste as tears), add between one to six drops of Lugol’s Iodine – vary each time to keep the MARCoNS off-balance. Use the Yogic technique wherein you set the bowl with iodine-water on the bathroom counter and bend over at the waist placing your face in the bowel. Blink your eyes a couple of times and then draw water up your nose to the back of your throat. I hold the solution in place briefly while tipping my head down and moving from side to side to flood sinuses before standing upright and allowing water to escape out of mouth – listen to BulletProof Radio Q&A May 2016 #312 at 25:30.
      Dave Asprey – Mycotoxins – The Surprising Mold You Eat
      Dave Asprey – BulletProof Executive
  • My Approach

    Alternative MARCoNS Treatment

    Update May 5, 2017

    Using nebulized Povidone-Iodine 1.25%, I knocked out a
    resistant Klebsiella oxytoca nasal infection and my wife
    knocked out MARCoNS without any negative side effects!
    Hospital Sinus Infection Outbreak Stopped With PVP-Iodine
    Update End

    I think Dave is right on when he said he had to keep after the MARCoNS for months before being able to clear them without BEG spray. Although BEG spray is very effective and all that is supposedly required to knock out MARCoNS, personally I’d use nasal washes in combination with the BEG spray (nasal wash 15 minutes before next BEG spray). Even after a course of BEG spray is completed, I’d follow by more washes and sprays for at least a couple of months. My sense is that these “bugs” are incredible tenacious and I wonder if they really are completely cleared even when a nasal culture comes back negative – that they’re not just hiding out in the deeper recesses of sinus and tooth canals.

  • Neti-PotPersonally, I really like ozonated water with Grossan Breathe-ease salt in a ceramic Neti Pot. I use a PlamaFire Beta V ozone generator but I’m sure there are less expensive models that will work just fine for ozonating water. I had a strong Herx reaction when treating a large amount of MARCoNS with ozonated water alone. Ozonated water isn’t harsh like Iodine or Hydrogen Peroxide can be and feels very healing to me. To keep the MARCoNS guessing, I’ll occasionally switch back-and-forth between colloidal silver and Xlear and Iodine as described below. Note: Although it seems a bit scary the first few times, just keep reminding yourself that even though your nose is filled with water, you can still breath through your mouth.

    After you’re comfortable doing a basic nasal wash, you can experiment with the Yogic practice of drawing the water from the neti pot through your nostril and gurgling it into your sinuses and the back of your throat. Place the tip of your tongue on the roof of your mouth behind your front teeth. With your head tipped down and while slowly pouring, inhale gently through your nose. Creating a slight suction draws water to the back of your throat where it’ll gurgle being trapped in the cavity formed between your tongue and the roof of your mouth. Move your head from side to side a bit and then let your tongue drop and the water to fall out before reaching the gag reflex. The trick is to pour slowly and remember to drop your tongue well before you trigger the choke point.

    Update November 2014
    I got a bit of what I believe was a sinus infection while treating with BEG spray and doing nasal washes. I believe this was most likely caused by doing the Yogic practice mentioned above wherein neti pot water is drawn deeper into the sinuses. In hind site, I’m thinking it may not be a good idea to use this technique when MARCoNS are present as you may end up pulling the infection deeper into the sinuses. This is not to say that ozone isn’t useful. On the contrary, the article, “Use of Gaseous Ozone for Eradication of Methicillin-Resistant Staphylococcus Aureus from the Home Environment of a Colonized Hospital Employee”, shows that ozone can knock out staph.In fact, if I ever get MARCoNS again, I’d seriously consider foregoing the use of BEG spray in favor of ozone applied directly into the nostrils and neti washes with colloidal silver and iodine.

    I’ve experimented with the method described by the nurse below wherein I place the 3/8” outer diameter silicone tubing from the ozone generator into one nostril while pinching the other closed and slowly exhaling the entire time through my mouth. I’m careful to close my eyes and to save enough breathe such that I can purge my nose when the tube is removed. I can feel the ozone working all the way to the back of my throat. You have to be careful to not let pressure build up or you’ll get a burning sensation (massaging below the eye and along the nose helps) as the concentration gets too strong at the blockage not to mention the possible damage to the ears via the Eustachian tubes – be careful!

    I pull the hose to the side such that my nostril is widened to help eliminate this problem while very lightly pinching the other nostril closed so it acts like a pressure relief valve just in case.You also have to be very careful not to breathe in concentrated ozone or you’ll be coughing hard for 15 minutes or longer in my experience – you only have to make this mistake once before you realize just how important it is to not inhale. I run the oxygen from a tank into a medical grade ozone generator at 1/2 L/min through a PlasmaFire Beta V generator and this equates to a concentration of 15 ug/cc. I bath each nostril for roughly 30 seconds two times each once daily. When I’m done, my nose will be runny similar to when treating with BEG spray. Besides BEG spray, this impresses me as being the most potent therapy for MARCoNS and fungi too.
    Update End
    Ceramic Neti Pot
    PlasmaFire Beta V Ozone Generator (check inventory before ordering)
    Grossan Breathe-ease Nasal Salt
    Use of Ozone for Eradication of Staph from Home
    Recurring Ear/Sinus Infection

  • I’ve used at most, one drop of 5% Iodine in a one-cup neti pot with some salt. Anything more, and it irritated my sinuses – slight burning sensation that went away after a day. Be gentle; don’t use too much Iodine.J.Crow’s Lugol’s 5% Iodine
  • One teaspoon of Hydrogen Peroxide in a one-cup neti pot gives a 1:40 ratio. Even at this concentration, my sinuses were slightly irritated. I do not think it’s a good idea to use either Iodine or H2O2 at levels that cause irritation. In my opinion, you’re just giving the MARCoNS an easy foothold. I’m not convinced about Hydrogen Peroxide in a nasal wash, but four drops in each ear with your head tipped to the side for a few minutes is great at stopping the onset of a cold in its tracks – along with tons of other uses for H2O2. I do this once a week while treating MARCoNS as the Eustachian tube ties into the throat/sinuses and I don’t want to give the MARCoNS a place to hide – I tend to get ear infections anyway.
  • Like Dave, I make a 50/50 mix of Xlear and Sovereign Silver in the Xlear spray bottle. Initially, I mixed about 1/2 teaspoon of Xlear with the rest being Sovereign Silver – just enough Xlear to prevent stinging. However, after reading the Chris Kresser article about xylitol and neti pots, I decided to increase the Xlear for its biofilm busting properties. If you’re interested, you can make your own high quality colloidal silver with a Colloidal Silver Master. Note: Lyme expert, Dr. Klinghardt, recommends using warm water in a neti pot with 1/2 teaspoon of salt, 1/2 teaspoon of Alkala or tri-salt baking soda, and 1 teaspoon of xylitol. According to Dr. Klinghardt, the bacteria are drawn to the Xylitol sugar that then causes them to bloat and die.

    By the way, I have used the method wherein you lay on your back with your head falling back over the edge of the bed and then put 20 or more drops of silver mix in each nostril. Afterwards, I found that it made my head really stuffy to the point that I was a bit off-balance and woozy. Much later, I read a post about how having your head back allows the liquid to enter the Eustachian tubes and this made total sense to me. I don’t recommend this method.

    Sovereign Silver
    The Highly Effective (But Little Known) Treatment For Chronic Sinusitis
    Colloidal Silver Master

Probiotic & Auto-Urine Nasal Sprays

Recently, I started reading about the use of probiotics in a nasal spray as a way of dealing with MARCoNS. I was introduced to this idea while listening to a 2014 talk by Dr. Klinghart wherein he claims that mold can grow in the nose, sinuses, back of throat, and jawbone and produce mycotoxins along the lines of Dr. Brewer’s work mentioned below. As an aside, I should show you the pictures of the infection at the base of a tooth with a root canal that I had extracted. It makes me wonder if MARCoNS and fungi were present.

Dr. Klinghardt goes on to discuss mixing up acidophilus bifidus in distilled water and using it several times throughout the day alternating with undiluted urine and another probiotic called Symbioflor2. Yes that’s right, according to Dr. Klinghardt undiluted urine contains fragments of bacteria cell walls that wake up the immune system to the presence of MARCoNS and fungi when sprayed in the nose 😕 According to Dr. Klinghardt, you can forego using antibiotics if you get the immune system engaged in the fight along with introducing healthy bacteria to supplant the bad MARCoNS. By the way, Dr. Klinghardt uses auto-urine therapy in homeopathic concentrations to treat the gut too – cup with mid-morning urine is emptied and rinsed out several times with water before being filled one last time with water and drank.

Update December 23, 2018
In Cavitations – NeuroQuant – And More, I discuss the recommendation by Lacto Bacto to use the probiotic Lactobacillus sakei. After snorting a smidge of this probiotic mixed in a 1/2 teaspoon of distilled water every morning for several weeks, lab testing six weeks after cessation of treatment came back with a completely clear report. This is amazing after so many years of clearing MARCoNS only to have them return after a short amount of time. We’ll see how long it holds, but for now, this is a very promising result.

Notes: I used Lacto Sinus brand in part because it comes packed with ice packs to maintain viability. I know of others that have used Pure L. Sakei Probiotic Powder but I can’t speak to its efficacy. Near the end of treatment, I started to get dizzy when working on my computer. After stopping the probiotics, the dizziness went away. Weird.
Update End

I haven’t tried auto-urine therapy but I did decide to experiment a bit with a probiotic nasal spray. After reading “The Chronic Sinusitis Cure” along with the posts below, I decided to use Natren brand “Megadophilus” containing lactobacillus acidophilus and “Bifido Factor” containing bifidum bifidobacterium mostly because these are very high quality probiotics that I had on hand. If I were going to buy probiotics for this purpose, I’d try “Enzymatic Therapy Acidophilus Pearls” containing lactobacillus acidophilus and bifidobacterium longum because it contains two of the four strains recommended in “The Chronic Sinusitis Cure” and are consistent with Dr. Klinhardts mention of acidophilus bifidus – acidophilus bifidus is a mixture of lactobacillus acidophilus and bifidobacteria.

In practice, I mixed up the equivalent of about one capsule of probiotics (mostly lactobacillus acidophilus) in a 30ml nasal spray bottle filled with distilled water. After shaking well, I saturated my sinuses in the morning and then again in the evening for 3 days. After the first day, I got a bit of sinus pain and a persistent headache. After 3 days, I decided to hold off on experimenting any further and went back to flooding my sinuses with ozone and netti washes – ah, felt much better. I may return to this later and try the Acidophilus Pearls.

The Chronic Sinusitis Cure
The Yeast Connection: A Medical Breakthrough
Sinus Health and Cleansing
Chronic Sinusitis Natural Treatment Protocols
Natural and Effective Sinus Infection Remedy
Enzymatic Therapy Acidophilus Pearls
Natren Probiotics

Fungal Colonization

In a December 2013 publication, Chronic Illness Associated with Mold and Mycotoxins – Is Naso-Sinus Fungal Biofilm the culprit?, Dr. Brewer makes the case that it’s not just MARCoNS (bacteria) that take up residence in nasal passageways but fungi too. This is not new information as Dr. Brewer sites many studies wherein fungi have been found in 91% of both folks with CRS (Chronic Rhinosinusitis) and healthy controls too. What’s new is the suggestion that the fungi are producing mycotoxins that make people sick. If this turns out to be true (there is controversy around how buttoned up this report is) it is extraordinary because we know mycotoxins make Biotoxin folks sick. So we know that fungi live in our noses but if they’re also producing mycotoxins, then we have to begin to think about treatments that not only knock out bacteria (MARCoNS) but also address mold colonies in the sinuses.

According to Dr. Brewer, the fungi protect themselves with biofilms just like bacteria and then go one step further by emitting mycotoxins. He goes on to site studies that have shown significant to dramatic improvement of symptoms in people treated with Amphotericin B as a nasal spray alone and also taken orally sometimes with biofilms busters like EDTA and NAC. Now I know there is controversy that questions the accuracy of mycotoxin measurements by Real Time Labs – see Urine Testing For Mycotoxins Junk Science or Not?. Furthermore, Dr. Shoemaker makes a strong case in Owls Under the Beaver Moon & Lessons on the Activity of Water that even though fungi that induce inflammation can grow in the sinuses, there simply isn’t enough free water in noses for the fungi to ever produce mycotoxins.

Nevertheless, if you take a bunch of folks with serious sinusitis or who are symptomatic after being exposed to mold and then see dramatic improvement in symptoms in up to 90% of the people, this is significant. So later on they may discover that nasal fungi don’t produce mycotoxins, but also that the relatively tame anti-fungal Nystatin was affording relief for some other reason than knocking down the fungal colonies in the nose. In any case, this treatment fits my requirements of being a relatively safe with real upside potential.

In the “Completely Updated and Revised Yeast Connection” by Dr. William Cook, the use of nystatin (another tame anti-fungal) in the sinuses is discussed. Here are two approaches he details. One, “shake your bottle of nystatin powder vigorously. Remove the cap and hold the bottle just under your nose. Sniff or inhale cautiously. Do this each time you take your oral nystatin. If you tolerate this procedure, gradually increase the amount you inhale over the course of several days. Usually 3 or 4 inhalations of nystatin “smoke” will allow the medication to settle on your deeper nasal and sinus membranes.” Two, “Buy a bottle of Ocean Mist Nasal Spray from your pharmacy. This is an isotonic saline nasal spray. Add 1/16 to 1/8 teaspoon of nystatin powder to the bottle and use one or two squirts in each nostril twice daily.”

Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome
Chronic Illness Associated with Mold – Is Naso-Sinus Fungal Biofilm the Culprit?
Mayo Clinic Study Implicates Fungus as Cause of Chronic Sinusitis
Real Time Labs

Olfactory Nerve

In addition to the documented benefit of using antifungal nasal spray and the suggestion that this therapy knocks out fungal colonies that are producing mycotoxins are statements made by Dr. Thrasher and Dr. Klinghardt. According to these Doctors, mycotoxins travel along the nerves in your nose and end up in the brain – not good. More specifically, Dr. Thrasher in The Biocontaminants And Complexity Of Damp Indoor Spaces wrote, “Aflatoxin B1 and probably trichothecenes are transported along the olfactory tract to the temporal lobe.” In a March 2012 interview, Dr. Klinghardt said that nasal fungi emit biotoxins that travel up the olfactory nerve into the limbic system and accumulate in the hypothalamus. These toxins then down-regulate neuro-regulatory hormones in order to hijack the hormones and neurotransmitters especially MSH and VIP. Relatedly, Dr. Klinghardt also said there is cross reaction with the immune system and with strep (Streptococcal Pharyngitis bacteria) in the throat, tonsil, adenoids, lymph in throat, and brain – called PANDAS now changed to PANS. When this happens the immune system attacks membranes in the brain. This leads to ticks, tourette syndrome, and compulsive behavior with strong overlap of symptoms with mold and Bartonella.

Update December 8, 2014 Below are my notes from a recent interview of Dr. Brewer by Dr. Nathan and Dr. Teitelbaum about the treatment of fungal colonies in the sinuses.

Mycotoxin Testing & Binders

  • Dr. Brewer found that Real Time Lab testing showed 93% of CFS patients had one or more mycotoxins in their urine compared to controls. Note: Per Dr. Shoemaker, Real Time Lab uses polyclonal antibodies to detect mycotoxins instead of monoclonal antibodies and polyclonal antibodies are susceptible to false positives. As an alternative, MicrobiologyDX (formerly Diagnostic Laboratory Medicine) in Bedford Massachusetts that does MARCoNS testing can also process nasal cultures for fungal strains. 781-276-4956
  • My Note: Setting the antibody issue asside, having mycotoxins in the urine does not necessarily mean folks have fungi in their noses. The test from Diagnostic Laboratory Medicine would seem to be much more definitive in this regard. Nonetheless, in terms of getting people better, we know from Dr. Brewer’s work that using antifungal nasal sprays along with biofilm busters works well. Even if nasal fungi can’t produce mycotoxins, and that the antifungals are working in some completely unknown way (maybe fungi are hiding in the roots of bad teeth too). These are important questions for Scientists to answer but I’m not going to wait until they figure it out before giving this promising therapy a try. 😉
  • Dr. Nathan makes the point that although there is some controversy around the quality of the test data, he sees real improvement in symptoms of Lyme, Chronic Fatigue, and Fibromyalgia patients that otherwise were not getting better when nasal fungi are treated. Dr. Nathan, Dr. Brewer, and Dr. Teitelbaum all agreed that symptom improvement correlates highly with decreased Real Time mycotoxin levels.
  • Real Time testing costs roughly $700 and has to be paid upfront – although most insurance companies will pay the “out of network” rate (Medicare does not cover the test).
  • Dr. Nathan has found that patients with negative tests could be “challenged” with 500mg of glutathione twice daily for a week to help improve their detox pathways. Upon re-taking the Real Time test on the 7th day, tests would come back positive. Dr. Brewer suggested saunas can also speed up toxin removal.
  • When used to aid detox, Dr. Teitelbaum believes it’s important to use a clinical glutathione in reduced form as a sublingual for good detoxification effects.
  • When test results show one or more mycotoxins are low in comparison to the others, they will often show up higher in later tests with or without detoxing. As such, its assumed patients with one positive mycotoxins test result most likely have all three mycotoxins and perhaps others.
  • Charcoal, Bentonite Clay, Cholestyramine (CSM), and Chlorella all work to bind toxins in the gut. Dr. Brewer says charcoal and CSM are pretty broad spectrum while Bentonite Clay is best with Aflatoxins.
  • Dr. Nathan says some patients can’t handle even small amounts of one or more of the binders most likely because the binders are pulling more toxins in the body than patients can handle. These folks need extra support with supplements and so on.

Nasal Fungi Treatment

  • Dr. Brewer found that oral antifungals like Sporanox (Itraconazole) and Vfend (Voriconazole) were too expensive, had many side effects, and weren’t particularly effective.
  • Dr. Brewer has tried nasal sprays with Ketoconazole, Sporonox, Amphotericin B, and Nystatin. Amphotericin B can be harsh causing burning, stuffiness, and nose bleeds – make sure to monitor. Sometimes a glutathione nasal spray will help with side-effects by reducing swelling. Sporonox causes very little irritation and Nystatin nearly none at all. Dr. Brewer has been using Nystatin for the last 6 months with promising results.
  • Woodland Hills Pharmacy says Dr. Brewer uses EDTA for biofilm busting along with Amphotericin-B 0.25% Nasal Spray. Administer EDTA in the morning and the Amphotericin B in the evening.
  • Dr. Nathan uses Ketoconazole or Nystatin nasal spray for those where Amphotericin B is too strong. Dr. Nathan also likes to use Hydrosol Colloidal Silver to help break up the biofilms along with an antifugal nasal spray.
  • Dr. Teitelbaum likes to use Bismoth and Hydrosol Colloidal Silver in a nasal spray for biofilms along with an antifungal, antibacterial, and sometimes Betamethasone to help shrink swollen nasal tissue.
  • Dr. Brewer and Dr. Teitelbaum find the Nystatin and Sporonox nasal sprays to be most effective.
  • Although not a complete solution, Dr. Teitelbaum says using Hydrosol Colloidal Silver as a nasal spray can make a big impact. Note: For half the price, you can buy your own amber colored spray bottles and Hydrosol Colloidal Silver – add a little Xlear to prevent stinging.
  • Dr. Brewer uses a special NasaTouch inhaler spray bottle from ASL Pharmacy to ensure good delivery. Note: NasaTouch has been replaced with the RhinoClear Sprint.
  • It’s essential to consistently use nasal sprays for 6 months or longer for good results.

Gut Fungi

  • To treat the gut, Dr. Nathan likes to use InterFase Plus to break up biofilms along with Sporonox. He also uses Hydrosol Colloidal Silver as it potentiates the antifungals.
  • To treat the gut, Dr. Teitelbaum likes to use diflucan for 6 weeks at 200mg a day along with Hydrosol Colloidal Silver and Bismoth (Pepto Bismol) for biofilms.

Update End

Note: For more information on antifungal nasal sprays, see Biotoxin Journey – Nasal Antifungals


Well, that’s it for now. MARCoNS can totally mess you up and it looks like fungal colonies in sinuses can too. Happily, testing for MARCoNS is straight forward. Although treatment with BEG spray is almost always successful, it can occasionally be rough. If it weren’t for the intense body aches I got after using BEG spray to treat MARCoNS, I’d use it again. If at all possible, I recommend using proven solutions – BEG spray for MARCoNS and Anti-fungals with a biofilm buster for fungi. I also recommend that anyone that does use BEG spray to take probiotics and binders like charcoal and clay to mop up toxins.

I’ve discussed several alternative approaches. To date, my preferred approach is flooding my sinuses with ozone (as it should be able to knock out bacteria, fungi, and biofilms) along with either neti washes using salt, Tri-Salts, and xylitol mixed in a 1:1:2 ratio in distilled water or in snorting a tablespoon of colloidal silver up each nostril. I like to experiment a bit and this just the latest method I’m trying. Whatever method you choose to use, test to confirm you were successful.