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In the fifteenth episode of The Healing Terrain, Dr. Emily Hernandez welcomes Keri Anania, PA-C, for a conversation about why antimicrobial protocols can fall short when the rest of the patient’s health is overlooked.
Anania is a certified physician assistant who works with patients facing a wide range of concerns, including pediatric neuropsychiatric conditions, autoimmune disease, hormonal imbalances, and digestive issues. Across those presentations, she begins with the gut and looks at the conditions that may be keeping the person from moving forward.
Her central message is that addressing unwanted organisms is one part of the process. In her approach, the plan also includes nourishment for beneficial microbes, attention to digestion and elimination, support for the gut lining, and a pace the patient can manage.
Start With the Gut
“When we see a new patient, we always start with the gut,” Anania said.
She explains that even when someone comes in for a concern such as hormonal imbalance, she wants to understand bowel habits and the broader picture of gut function before building a plan.
Regular bowel movements are part of that conversation, but she also looks beyond frequency. Two people may have similar findings on testing while experiencing very different symptoms. For Anania, that is a reason to consider the gut within the context of the whole person.
Hernandez connects this approach to the episode’s larger theme: understanding why a patient developed an imbalance in the first place, then addressing the factors that may allow it to return.
Include Biofilms in the Conversation
Anania describes Biocidin as a botanical formula she frequently uses in practice and calls herself a “Biocidin superfan.” She highlights its broad-spectrum approach and the importance she places on addressing biofilms.
Hernandez explains biofilms as communities of microbes within a sticky protective matrix. Their discussion explores how that structure can make organisms harder to reach and why Anania considers biofilms when planning microbial support.
Published laboratory research evaluated Biocidin against biofilms formed by four bacterial species and the yeast Candida albicans. The study documented reductions in viable microbial populations under the tested conditions. This research connects with Anania’s discussion of biofilms and microbial balance.¹
A separate laboratory study evaluated Biocidin Liquid and Biocidin LSF against Borrelia burgdorferi, including its spirochete, round-body, and biofilm forms. Both formulas showed antimicrobial activity in the laboratory experiments.²
For Anania, that microbial work belongs within a plan that also considers how the patient is digesting, eliminating, and tolerating the process.
Build Support Around the Antimicrobial Protocol
Anania emphasizes liver and gallbladder support, binders, and attention to the gut lining as parts of the protocols she develops. She discusses lipopolysaccharide, or LPS, in explaining why she wants practitioners to think beyond the organisms they are targeting.
Among the products she mentions are G.I. InnerCalm for the gut-lining component of her approach and liver-support formulas. She also considers digestive enzymes, stomach acid, and gallbladder function when deciding what a patient’s plan needs. Together, these tools reflect her emphasis on supporting the patient throughout the protocol.
When discussing small intestinal bacterial overgrowth, or SIBO, Anania describes pairing Biocidin with Olivirex and refers to published research on that combination of tools.
A 2024 open-label clinical study enrolled 16 adults with breath-test-confirmed SIBO and evaluated Biocidin Liquid Tincture with GI Detox+ over 10 weeks. Olivirex was added for an additional four weeks in participants whose breath tests remained positive. Researchers reported negative breath tests in participants with hydrogen- and hydrogen-sulfide-dominant SIBO and changes in gut microbiome composition.³
Anania’s broader point is that choosing an antimicrobial is only one decision. The accompanying support and the patient’s individual needs also shape her plan.
Nourish the Microbiome
“You can’t just go modulate the microbiome and eat whatever you want,” Anania said.
She brings the discussion back to food, with an emphasis on prebiotics, fruits, vegetables, whole grains, and a variety of colors. She also discusses postbiotics and short-chain fatty acids as part of her thinking about the gut environment.
Hernandez describes this as supporting the terrain alongside the work of addressing overgrowth. Anania asks whether the gut lining has been addressed, whether the person chews slowly, and whether the nervous system is continually in fight or flight.
They also discuss patients who have stayed on restrictive diets for months or years. Anania describes dietary changes as therapeutic tools and emphasizes working toward more variety as the patient progresses. Hernandez similarly presents temporary adjustments as one part of a plan that must fit the person’s circumstances.
Look at the Daily Foundations
Anania encourages practitioners to keep asking basic questions even when a case is complicated. Is the patient sleeping? Moving? Drinking water? Having regular bowel movements?
She describes how easy it can be to become absorbed in a supplement protocol and overlook something as simple as a person drinking very little water throughout the day.
The nervous system is another part of her assessment. She and Hernandez discuss patients who have been dealing with symptoms for so long that they feel overwhelmed or have lost confidence in their bodies.
Within their approach, the sequence matters. They describe building a foundation through drainage, detoxification support, nutrients, and attention to inflammation while considering the patient’s sensitivities and tolerance.
Reduce Environmental Exposures One Step at a Time
The conversation also extends beyond food and supplements to skincare, cleaning products, fragrance, and the water people drink.
Anania knows that changing everything at once can overwhelm a patient. Her approach is to choose one place to start, then make additional changes over time.
“When they run out, buy the clean one,” she said, describing how she approaches replacing products over time.
She mentions the Environmental Working Group’s Skin Deep resource for reviewing skincare ingredients, along with its Dirty Dozen and Clean Fifteen guides as resources she discusses with patients when prioritizing produce purchases.
Anania also names Branch Basics® as a cleaning line she personally loves. She describes using it for hand soap, household cleaning, laundry, and stain removal, and says its convenience makes it easy to incorporate into her routine.
Her practical message is to start with a manageable change. Both speakers encourage looking at ingredient lists rather than relying only on terms such as “natural” on the label.
Meet the Patient Where They Are
“Meet the patient where they’re at,” Anania said. “It’s a journey, right? Healing should be a journey.”
She explains that a long list of expectations can leave someone overwhelmed before they begin. Listening closely helps her identify where to start and what the patient can realistically take on.
Hernandez shares a similar reminder from her own experience: a complicated case does not require addressing every issue in one visit. A thorough conversation can reveal the foundation that needs attention first.
Anania also emphasizes understanding the products being used and adjusting the starting point to the patient’s sensitivities. Her goal is to combine microbial work with the support the person needs throughout the process.
“We are rebalancing, right? It’s all a harmony,” she said.
Practical Takeaways From the Conversation
Anania and Hernandez return to several themes throughout the episode:
· Begin with gut function and bowel habits, even when the presenting concern extends beyond digestion.
· Consider biofilms as part of the discussion about microbial balance.
· Include digestion, elimination, gut-lining support, and the patient’s tolerance when planning care.
· Keep nourishment for beneficial microbes and dietary variety in the conversation.
· Ask about sleep, hydration, movement, and the nervous system alongside the supplement plan.
· Approach changes to household and personal-care products one step at a time.
· Meet the patient where they are and choose a manageable starting point.
The episode’s answer to why antimicrobials alone don’t work comes back to Anania’s emphasis on the whole picture. In her practice, microbial balance is addressed alongside the daily habits, digestive foundations, and environmental factors that shape the patient’s terrain.
Listen to the Full Episode
Listen to Episode 15 of The Healing Terrain with Keri Anania, PA-C. Find the podcast on DrTalks, Apple Podcasts, Spotify, and YouTube.
References
1. Mundanchira AV, Wong A, Klos-Maki K, Strand J, Marques CNH. Activity of Biocidin® against microbial biofilms. Frontiers in Antibiotics. Published January 28, 2026. doi:10.3389/frabi.2025.1692653.
2. Karvonen K, Gilbert L. Effective killing of Borrelia burgdorferi in vitro with novel herbal compounds. General Medicine Open. 2018;2(6). doi:10.15761/GMO.1000153.
3. Min M, Nadora D, Chakkalakal M, et al. An Oral Botanical Supplement Improves Small Intestinal Bacterial Overgrowth (SIBO) and Facial Redness: Results of an Open-Label Clinical Study. Nutrients. 2024;16(18):3149. doi:10.3390/nu16183149.
Trademark and Product Disclaimer
Branch Basics® is a registered trademark of The Power of Pure, LLC. The brand is mentioned to identify the product line discussed by the guest. The mention reflects Keri Anania’s personal preference and does not imply sponsorship, affiliation, or endorsement by Branch Basics. All other trademarks belong to their respective owners.
These statements have not been evaluated by the Food and Drug Administration. Dietary supplement products are not intended to diagnose, treat, cure, or prevent any disease.
This content is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment.
