Lactoferrin is a molecule found in milk that has a range of health benefits and uses. Lactoferrin is an iron-binding protein found in blood, tears, semen, vaginal secretions, and sweat as part of our first line of immune defence.
As part of this first line defence, lactoferrin is also found in abundance in milk, including human breast milk, as a baby’s first immune system.
Because it is found in such abundance in milk, lactoferrin is as a result thought of as a milk protein. This important protein serves many functions, including having wound-healing, anti-tumour, antiviral, antifungal, antibiofilm, anti-inflammatory and antibacterial properties1,2.
Human milk can have high lactoferrin concentrations, with colostrum having significant amounts. Blood concentration is much lower by comparison but increases at the site of a wound, with inflammation.
Lactoferrin can boost low iron stores, damage biofilms and disruptive bacteria, viruses and parasites, and promote immunity.
Skip to Section
Types of lactoferrin: apo and holo
There are two main types of lactoferrin: apo-lactoferrin and holo-lactoferrin. Apolactoferrin is free of iron, while holo-lactoferrin (usually called bovine lactoferrin) is already bound to (saturated with) iron. Both apolactoferrin and bovine lactoferrin originate from cow’s milk.
There is some evidence1 to suggest that iron absorption is greater from apolactoferrin, but both forms of lactoferrin promote iron absorption without the most common side effects of iron supplements.
Holo-lactoferrin may have better immune modulating effects than apo-lactoferrin, but both have their pros and cons, depending on how and where they are used. We use either holo-lactoferrin or apo-lactoferrin orally, and usually only apo-lactoferrin vaginally.
Apo vs. holo
| Feature | Apo-lactoferrin (iron-depleted) | Holo-lactoferrin (iron-saturated) |
|---|---|---|
| Iron content | Contains very little iron (almost ’empty’). | Already filled (‘saturated’) with iron. |
| Appearance/colour | Typically lighter or nearly white. | Can be pinkish or reddish because of the iron. |
| Main action against bacteria | Binds (soaks up) iron in the body or on surfaces, starving harmful bacteria of the iron they need to grow. | Still has some antimicrobial effects, but does not soak up extra iron since it is already filled with iron. |
| Why it can help with BV | – Removes iron from the vaginal area, making it harder for harmful bacteria (like those involved in BV) to thrive. – Helps support good bacteria (e.g., Lactobacillus) that prefer lower iron environments. | – Can still help fight harmful bacteria to some extent, but less effective at reducing iron levels that bacteria rely on. |
| Benefits to vaginal health | – Excellent for iron-starvation of undesirable bacteria. – May help re-balance vaginal flora. – Often used in formulations aiming to limit bacterial growth. | It still has some antimicrobial effects but does not soak up extra iron since it is already filled with iron. |
| Forms and uses | – Often found in supplements (oral capsules or vaginal suppositories/gels) specifically marketed for antimicrobial support. – Look for apo-lactoferrin or “iron-free lactoferrin” on the label. | – Sometimes used in immune-boosting or specialised products. – Labeled holo-lactoferrin, bovine lactoferrin or iron-saturated lactoferrin. |
| When to consider | – If you specifically want to reduce iron that feeds harmful bacteria in the vagina or gut. – For addressing issues like bacterial vaginosis, especially with other supportive measures (e.g. probiotics, vaginal pessaries). | – If you have a more complex health concern involving iron balance or immune support. – Not the best choice if your main goal is to “steal” iron from bacteria. |
| Safety and tips | – Generally recognised as safe; check with a healthcare provider if pregnant, nursing, or dealing with chronic conditions. – Often well-tolerated but always follow product instructions. | – Generally safe too, but it’s always a good idea to consult a healthcare professional for personalised advice. |
How lactoferrin affects bacteria
The iron-binding (chelating) effects of lactoferrin may play the greatest role in its action as an antimicrobial, but it is a very multidimensional protein.
Lactoferrin as an antimicrobial
Lactoferrin has direct bacteriocidal actions that are independent of the iron-binding activity, and can disrupt bacterial membranes.
Iron is essential for most bacteria to survive, playing a role in regulating cellular and metabolic functions, including DNA synthesis, energy production, etc.
Lactoferrin is effective against urinary tract infections (UTIs), and has a normalising effect on the gut microbiome, particularly in cases of irritable bowel syndrome (IBS).
Lactoferrin increases the efficacy of other antimicrobial agents, so here in My Vagina’s specialist clinic, we tend to use lactoferrin in combination with other treatments.
Bacteria do not appear to develop resistance to lactoferrin. This is no doubt a purposeful manifestation of nature since milk is the first food of many mammals.
Bacteria that need iron
Many disruptive vaginal bacteria, such as Gardnerella spp., Escherichia coli (E. coli), and Staphylococcus aureus, have active iron-collecting mechanisms and rely on this mineral. Thus, limiting the local availability of iron in the vaginal tract can reduce the virulence and growth of these unwanted guests.
Beneficially, protective lactobacilli species can take or leave iron, so reducing local iron supplies gives lactobacilli a competitive advantage.
Free iron levels in the vagina are usually low, but during menstrual bleeding, levels shoot up, offering iron-dependent bacteria much-needed resources.
Why would I want iron if the bacteria are using it?
Our iron reserves are important for immune function, and menstruating people are prone to low stores, which can negatively impact immunity and result in heavy menstrual bleeding.
Heavy periods are counter to our goal and provide even more iron to vaginal bacteria while also increasing the pH to favour pathogens. Ensuring sufficient iron availability is important for overall health.
Our bodies naturally ‘hide’ iron when we have infections to stop the bacteria from stealing it. This can make less iron available for our daily activities, so treating infections is important for normal iron use.
Iron deficiency – is my iron being stolen by bacteria?
If you have iron deficiency or at every test you get, you’re always low despite eating plenty of iron-rich foods, and you may find you’ve got some iron robbers in your gut.
Bacteria can steal the iron from your food or supplements in the digestive system, and use iron in biofilms. Treating your gut and gut microbiome may be an important part of healing for you, in multiple ways. Do not take regular iron supplements if you are treating any infection.
How lactoferrin affects biofilms
Iron is also essential for biofilm development and growth. The most studied bacteria include Pseudomonas aeruginosa, E. coli, and S. aureus, which all use iron to support their biofilm matrix. Lactoferrin can interfere with a biofilm’s structural ‘glue’ component, reducing its strength.
But before the biofilm is built, the bacteria must adhere to the mucosal surface. Lactoferrin can attach to bacterial surfaces or membranes, making adhesion more difficult.
Building a biofilm takes teamwork. By binding to iron in the environment, bacteria lose some of their ‘walkie-talkie’ communications, known as quorum sensing. This results in bacteria being less organised and efficient.
Lactoferrin likely works as its own team with other immune substances to inhibit pathogens, as it is not usually found on its own in body fluids.
Bacteria won’t go down without a fight, though. Some bacteria can sniff out the iron in the lactoferrin, and secrete enzymes that can strip lactoferrin of its iron.
Lactoferrin as an immune booster
Lactoferrin can bind to certain receptors on immune cells and influence their activity. One of the most important of these functions is the ability of lactoferrin to enhance the activity of the white blood cells that ‘eat’ and kill pathogenic bacteria (a process called phagocytosis).
Lactoferrin can also boost the immune functions that clear away infected or malignant cells.
Lactoferrin as an anti-inflammatory
Lactoferrin can increase and decrease the activity of pro-inflammatory or anti-inflammatory signals (cytokines).
If we need inflammation to draw helpful resources to an area (like in the early stages of an infection when we need inflammation to help fight pathogens), lactoferrin will send support signals. If an area needs inflammation dampened, lactoferrin reduces the signals calling for inflammation.
Using lactoferrin orally and vaginally to treat BV
We use lactoferrin, both apo-lactoferrin and holo-lactoferrin, in different ways, and it depends on our goals as to how it’s used.
Using lactoferrin orally
Use bovine holo-lactoferrin as directed on the label or as your practitioner advises. Take lactoferrin with or without food. Holo-lactoferrin supports the immune system a little better than apo-lactoferrin.
Holo-lactoferrin is already bound to iron, a great source of bioavailable iron to replenish stores.
Safety when using oral apo- or holo-lactoferrin orally
- Don’t use holo-lactoferrin if you have haemochromatosis or a dairy allergy.
- Safe for use during pregnancy and breastfeeding, even recommended during pregnancy to support typically low iron in this time
- Avoid in gut infections or gut dysbiosis, use apo-lactoferrin instead to be on the safe side – it still provides a good source of bioavailable iron from food, take with iron-containing meals e.g. with red meat
Vaginal use of lactoferrin
Use 20mg apo-lactoferrin inserted deep vaginally in a vegetable capsule. It’s important to use apo-lactoferrin vaginally, since you want it to bind to the local iron to make it as inaccessible as possible for pathogens.
Apo-lactoferrin keeps its antimicrobial and antibiofilm activities, including the ability to disrupt bacterial membranes, when used vaginally.
If your apo-lactoferrin comes in enteric-coated capsules, see how to switch capsules, and if the doses are too high, order vagina-safe vegetable capsules to split powder doses.
Use deep vaginally at night. The duration of use will depend what else you are doing, but it is good as as general rule to use treatments for no longer than seven days consecutively then take a break and check symptoms and pH. You can use apo-lactoferrin by itself and see how the treatment goes.
If using other vaginal Killing BV treatments, use during the day instead.
Safety when using apo-lactoferrin vaginally
- If the capsules or powder cause irritation, discontinue use.
- Do not use if you’re allergic to any of the ingredients.
- Check with your healthcare provider before using during pregnancy.
References2–5
- 1.Mikulic N, Uyoga MA, Mwasi E, et al. Iron Absorption is Greater from Apo-Lactoferrin and is Similar Between Holo-Lactoferrin and Ferrous Sulfate: Stable Iron Isotope Studies in Kenyan Infants. The Journal of Nutrition. Published online December 2020:3200-3207. doi:10.1093/jn/nxaa226
- 2.Lönnerdal B, Bryant A. Absorption of iron from recombinant human lactoferrin in young US women. The American Journal of Clinical Nutrition. Published online February 2006:305-309. doi:10.1093/ajcn/83.2.305
- 3.Jiang R, Lopez V, Kelleher SL, Lönnerdal B. Apo‐ and holo‐lactoferrin are both internalized by lactoferrin receptor via clathrin‐mediated endocytosis but differentially affect ERK‐signaling and cell proliferation in caco‐2 cells. Journal Cellular Physiology. Published online August 24, 2011:3022-3031. doi:10.1002/jcp.22650
- 4.Pino A, Giunta G, Randazzo CL, Caruso S, Caggia C, Cianci A. Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial. Microbial Ecology in Health and Disease. Published online January 1, 2017:1357417. doi:10.1080/16512235.2017.1357417
- 5.Ammons MC, Copié V. Mini-review: Lactoferrin: a bioinspired, anti-biofilm therapeutic. Biofouling. Published online April 2013:443-455. doi:10.1080/08927014.2013.773317
Specially formulated probiotic for vaginal application to promote a healthy vaginal microbiome.
The BV Vaginal Pessary has been superseded by our new, more powerful BV treatment, BV Rescue! For penises and vaginas.
Unique, comprehensive BV, AV and 'mystery bad vag' treatment guide, one-of-a-kind system, with effective, innovative treatments.
