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4R Treatment Protocol – Guidelines & Supplement Suggestions


The 4R Protocol is a widely accepted clinical guideline to treating pathogens and imbalances in the GI microbiota. Use this practical guide to support restoring health to the gastrointestinal tract. Follow the sequence with suggestions to support your patient to restore their GI health.  You can also download this guide as a PDF document to print.

4R Treatment Protocol – Guidelines & Supplement Suggestions

One of the most effective functional medicine treatment options to restore the health and balance of a patient’s microbiota is the “4R Treatment Protocol.” This provides a protocol guide with four main components: Remove, Replace, Reinoculate and Repair / Rebalance.

The GI-Map test can provide useful indications and clarity to prepare an appropriate protocol. Monitor the progress of the patient and re-test with the GI-Map in 3-6 months and make changes to the protocol as needed.

1. Remove

Using a course of antimicrobial, antibacterial, antiviral or antiparasitic therapies in cases where organisms are present. It may also be necessary to remove offending foods, gluten, or medication that may be acting as antagonists.

4R & GI-Map Instructions



Oil of oregano, berberine, caprylic acid, garlic oil


Liquorice, zinc carnosine, mastic gum, tribulus, berberine, black walnut, caprylic acid, oil of oregano


Oil of oregano, caprylic acid, berberine, black walnut, garlic oil


Artemesia, black walnut, berberine, garlic oil, oil of oregano


Cat’s claw, berberine, echinacea, vitamin C, vitamin D3, zinc, reishi mushrooms


Oil of oregano, protease

2. Replace

In cases of maldigestion or malabsorption, it may be necessary to restore proper digestion
by supplementing with digestive enzymes.


Betaine hydrochloride, tilactase, amylase, lipase, protease, apple cider vinegar, herbal bitters

Recolonisation with healthy, beneficial bacteria. Supplementation with probiotics, along with the use of prebiotics helps to re-establish the proper microbial balance.

3. Reinoculate

Recolonisation with healthy, beneficial bacteria. Supplementation with probiotics, along with the use of prebiotics helps to re-establish the proper microbial balance.


Slippery elm, pectin, larch arabinogalactans, acacia gum, PHGG, chicory root inulin, glucomannan, apple pectin, flaxseed


Bifidobacterium animalis sup lactose, lactobacillus acidophilus, lactobacillus plantarum, lactobacillus casei, bifidobacterium breve, bifidobacterium bifidum, bifidobacterium longum, lactobacillus salivarius sup salivarius, lactobacillus paracasei, lactobacillus rhamnosus, Saccaromyces boulardii

4. Repair and Rebalance

Restore the integrity of the gut mucosa by giving support to healthy mucosal cells, as well as immune support. Address whole body health and lifestyle factors so as to prevent future GI dysfunction.


Saccaromyces boulardii, lauric acid


L-Glutamine, aloe vera, liquorice, marshmallow root, okra, quercetin, slippery elm, zinc carnosine, Saccaromyces boulardii, omega 3 essential fatty acids, B vitamins


Sleep, diet, exercise, and stress management


VIDEO: Dr David Brady Introduces the 4R Treatment Protocol

Dr David Brady shares his clinical experience of the GI-Map test in practice. He uses the ‘4-R Treatment protocol’ as a useful guide to engaging in an effective clinical process for appropriate diagnosing and sequencing of patient recommendations and treatment protocols… you feel it necessary, a retest can be done after your treatment protocol is carried out. 

Source: Live interview with Dr David Brady, December 2018, Sydney Australia. See the video with a full reference transcript here…

        Designs for Health Australia proudly presented the

Gl-Map Seminar

Learn about the clinical applications and the research behind this new DNA/PCR stool test.

Presented by Dr David Brady, Chief Medical Officer for Diagnostic Solutions Laboratories and Dr Oscar Coetzee, Doctor of Clinical Nutrition and Associate Professor.


•  This in-depth live seminar recording is now available here to DFH Registered Practitioners…

GI-Map Event Recordings