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Herbal antibiotics vs. Rx, prokinetics, probiotics, and lists upon lists of low-FODMAP foods… there’s a lot to keep track of when you’re dealing with Small Intestine Bacterial Overgrowth.
And that might be why one of the most important tools we have for SIBO doesn’t get enough credit: digestive enzymes.
This simple supplement might be the most important supplement you use for feeling good day to day and supporting overall health.
Let’s break down how, why, and when to use digestive enzymes, plus what to look for when choosing a formula.
What Are Digestive Enzymes?
Digestive enzymes help us break down the food we eat into molecules that can be absorbed and used by our body.
I like to think of it like this: imagine your digestive system is a dishwasher and the food you eat are the dirty dishes you load into the dishwasher. Digestive enzymes are like the soap you add to the dishwasher.
Without the soap, the water alone will be able to get the dishes somewhat clean… but when you add the soap in, the dishes come out sparkling clean.
We get digestive enzymes in two ways: our body produces some digestive enzymes on its own in the saliva, pancreas, liver and gallbladder, as well as on the lining of the intestines, and there are also naturally-occurring digestive enzymes in many foods.
The three primary digestive enzyme types are:
Protease – breaks down protein
Lipase – breaks down fat
Amylase – breaks down starches
But there are many more types of enzymes, including brush border enzymes, which are in the lining of the small intestine and include lactase, which breaks down the milk sugar lactose, and sucrase for breaking down sucrose.
When Digestive Enzymes Go Wrong
Ideally, you should get plenty of digestive enzymes from the food you eat and your body’s own production…
But for many reasons, people are often left with inadequate digestive enzymes. These are some common reasons for inadequate digestive enzymes:
- Genetic predisposition (common with lactose intolerance)
- Crohn’s disease
- Exocrine pancreatic insufficiency (EPI)
- Cystic fibrosis
- Leaky gut
- And of course… SIBO!
When you’re lacking enzymes, you might notice:
- Dyspepsia (aka feeling bad when you eat)
- Dull hair, skin, and nails
- Undigested food in stool
- Food intolerances
How Digestive Enzymes Can Help People With SIBO
Digestive enzymes can benefit many – maybe even most – people, but for those with SIBO they are especially important.
They reduce symptoms. Digestive enzymes can reduce bloating, gas, constipation, and diarrhea – some of the most uncomfortable SIBO symptoms there are.
They can help expand your diet. Many people find digestive enzymes expand their list of “safe foods” and that they can even incorporate more FODMAPs thanks to added digestive enzymes. Check out Dr. Mark Pimentel on Fiber, The Low-FODMAP Diet , and What To Eat During SIBO Treatment.
They improve nutrient absorption. Whether you’re struggling with weight gain OR loss as a result of SIBO, digestive enzymes can boost nutrient absorption, helping to naturally balance your weight.
When and How To Use Digestive Enzymes
Digestive enzymes can be used in two ways, according to Dr. Allison Siebecker, ND:
With food: Take the enzymes at the start of a meal, so they can begin to digest the food right as you begin eating it. If needed, more enzymes can be taken mid-meal or at the end.
Without food: When taken without food, digestive enzymes have an anti-inflammatory effect. They can even have an anti-biofilm effect when taken away from food.
Both uses can be very beneficial for people with SIBO and you may want to experiment with both.
Choosing The Right Digestive Enzyme
Understanding why and how to use digestive enzymes is the easy part… the tricky part is choosing the right product.
Here’s what I look for:
- Contains brush border enzymes, in addition to lipase, amylase, and protease.
- High enough dose, because many supplements have far too low a dose to be effective!
- Vegan and allergen free, because many supplements are made from animal products.
- Contains activated enzymes – this is MOST important. Enzymes require activation by a cofactor. If you don’t have what the enzyme requires to be activated, it doesn’t do any good. That’s why choosing an activated enzyme is key to getting good results.
My Digestive Enzyme Pick
I’ve tried just about every digestive enzyme on the market, and Healthy Gut HoloZyme is my favorite by far.
It’s vegan, free of fillers, and has only activated enzymes. This formula is so different from other digestive enzymes, it has a patent. Plus, its effectiveness is backed by 6 pilot clinical studies.
There’s too much to list here, but if you want to see exactly how HoloZyme stacks up compared to other big digestive enzyme brands, click here and scroll to the bottom of the page for a comparison chart.
Plus, Ive negotiated a special discount just for our community: $15 off AND free shipping.
Using digestive enzymes has made a huge difference for me… and if you’re suffering with SIBO or IBS, I hope it can help you, too.
Hope & hugs,
PS – Got questions about HoloZyme? Leave a comment with your question and I’ll do my best to answer it.
Whether it’s a birthday, a wedding, or just a day when you want to enjoy a sweet treat… can you have your cake and have SIBO too?
With this amazing cake recipe, you can!!
SIBO expert (and patient, too!) Dr. Allison Siebecker shared this recipe with me from her personal files.
I’ve even had the pleasure of eating this cake, prepared by Dr. Siebecker.. And let me tell you, it doesn’t disappoint!
I hope you enjoy this cake recipe as much as I have for your upcoming special occasions.
Information and Substitutions
This recipe uses coconut flour. I know what you’re thinking… “But coconut flour is HIGH FODMAP!”
Remember that the serving size is the most important factor when it comes to what foods are and aren’t tolerated on a SIBO diet.
According to Dr. Siebecker’s SIBO-specific food guide, a ¼ cup serving of coconut flour is low-FODMAP and a “green food.”
This recipe calls for a total of ½ cup coconut flour… which means as long as you don’t eat the entire cake in one sitting, it will be low-FODMAP.
For most people with SIBO, coconut flour is tolerated in servings of ¼ cup or less at a time.
Because it is highly absorbent, you can’t easily substitute other flours – like almond or gluten-free flour blends – for the coconut flour in this recipe. If you don’t tolerate coconut flour, this recipe might not be right for you.
One last thing… flax eggs or other egg substitutions haven’t been tested. If you try out an egg substitute, let us know how your cake turns out in the comments!
SIBO-Friendly Vanilla Cake (Low-FODMAP, Gluten Free)
Shared by Dr. Allison Siebecker, adapted from Elana’s Pantry
½ cup coconut flour, sifted
½ teaspoon celtic sea salt
¼ teaspoon baking soda
6 large eggs
½ cup grapeseed oil
½ cup clover honey or maple syrup
1 tablespoon vanilla extract
In a medium bowl, combine coconut flour, salt and baking soda.
In a small bowl, blend together eggs, grapeseed oil, honey or maple syrup, and vanilla.
Mix wet ingredients into dry and blend with a mixer or hand blender until smooth.
Pour batter into lined or well-oiled muffin pan or 8-inch cake pan.
Bake at 350°F for 20 minutes or until a toothpick inserted comes out clean.
Cool completely before topping with chocolate frosting (recipe to follow).
SIBO-Friendly Rich and Creamy Chocolate Frosting
Shared by Dr. Allison Siebecker
- 1 oz Baker’s unsweetened chocolate (previously 1 square, now 4 squares)
- ½ cup butter
- ½ cup clover honey
- ½ cup unsweetened cocoa powder (such as Ghirardelli or Droste)
- 1 tablespoon vanilla
Melt unsweetened chocolate square and butter in a double boiler or in the microwave on low
Allow to cool for 15 minutes, then transfer to a mixing bowl. Add the honey, cocoa and vanilla and beat until fluffy (using an electric beater or mixer).
Notes: cooling chocolate and butter before proceeding prevents honey from dropping to bottom.
I know how frustrating it can be to feel like all “fun foods” are off the table because of SIBO. I hope this recipe helps bring some joy to your day.
For more of my favorite SIBO-friendly recipes, be sure to download my free cookbook HERE.
As the days pass, I’ve been thinking more and more about how to make the most of the situation we are in.
For the first time in YEARS, I have no plans on the calendar for the next month.
No dinners, no weddings, no work functions. It’s just me, my husband, and the cats for the foreseeable future.
Which means I have NO excuse to not start the Elemental Diet.
What does that mean? Why would I be trying a diet right now? (It isn’t about weight loss)… and why do I think it might be the perfect time for you, too? Let me explain…
What Is An Elemental Diet?
The Elemental Diet is the only diet that can actually resolve SIBO completely, and it’s one of the most effective treatments we have available. Elemental diets starve bacterial and fungal overgrowths. They’re easy to digest, giving your gut a chance to rest and repair. And they reduce exposure to irritants.⠀
The Elemental diet is an all-liquid diet that can help repair the gut, kill bacterial overgrowth, and reduce inflammation. On the Elemental diet, you’ll drink a specially formulated blend of nutrients to get your daily calorie needs met.
This isn’t a regular protein powder, though: the proteins in the Elemental diet are broken down into the most elemental form – amino acids. The carbohydrates in the Elemental diet are fully digested, and so it essentially contains no fiber which can be very helpful for sensitive guts.
I think of it as eating all your nutrients “pre-digested” to both completely eradicate bacteria (which feast on undigested carbs) and give your gut a much-needed break.
3 Ways To Use The Elemental Diet
There are 3 ways to use the Elemental Diet:
#1 Gut Friendly Meal Replacement
You can use the Elemental Diet to replace any meal with highly digestible nutrients and give the gut a break. If you’ve been looking for SIBO-friendly protein powder or meal replacement shake, this is it!
Use as a gut-healing meal replacement shake. Elemental Heal can be safely used long term to replace 1-2 meals per day. It’s a complete meal replacement but also predigested, giving your gut a chance to rest and heal.
#2 Gut Reset: 2-4 Days
This is an easy way to stop a flare of gut symptoms and give your gut a rest. Suggested use is to replace all meals and snacks with Elemental Diet for 2-4 days.
#3 SIBO Healing: 1-3 Weeks
When used for 1-3 weeks, the Elemental Diet can resolve even stubborn SIBO cases. Suggested use is 1-3 weeks of replacing all meals and snacks with Elemental Diet.
Why Now Is A Great Time For The Elemental Diet
If you decide to use the Elemental Diet as a SIBO treatment, the hardest thing about following it for most people is fitting it into a busy schedule.
Right now, many of us have clear schedules… which can make 1-3 weeks on the Elemental Diet perhaps feasible for the first time ever.
Even if you don’t want to commit to a full Elemental Diet, having it on hand right now makes sense. It’s a simple meal replacement that won’t flare up symptoms and make you feel worse.
I’ve seen several people posting in the facebook group about struggling to find SIBO-friendly foods right now… having the Elemental Diet on hand means you always have something SIBO safe ready to eat.
Choosing The Right Formula For You
Until recently, there were two options for the Elemental Diet:
- Prescription mixes (require a doctor’s order and many taste disgusting)
- Homemade recipes (require specific ingredients and a lot of prep work)
Luckily, SIBO expert Dr. Michael Ruscio has now developed a third option for all of us: Elemental Heal.
Elemental Heal is by far the best tasting and easiest elemental diet option… it’s a powder (in chocolate or vanilla) that you mix with a small amount of oil and water.
It’s available without a prescription, so you can keep it on hand for meal replacements and “gut resets.”
And no matter your needs, there’s an option for you:
- Traditional, which comes in Chocolate and Vanilla
- Whey-free, for those who don’t tolerate whey protein
- Low-Carb, which has just 20 grams of carbohydrates per serving
These new formulations have been in the works for months, and are finally ready to ship. I’ve been looking forward to sharing this new resource with you, and the timing couldn’t be better.
How To Learn More & Get 15% Off
I’m taking this time to focus on my health, and there has never been a better time for the Elemental Diet than right now.
If you’re interested in joining me on the Elemental Diet, I asked Dr. Ruscio for an exclusive discount for you. Right now, the SIBO SOS® Community can get 15% OFF all Elemental Heal (including low-carb and whey free!).
Want to learn more? Watch this Q&A with Dr. Ruscio
I sat down for a truly enlightening and very frank discussion on the risk of Covid-19 for people with SIBO, leaky gut, and other gut issues with double-board-certified gastroenterologist and internal medicine doctor Ken Brown. Also, the founder of Atrantil.
How will the coronavirus impact people with gut issues? What do we need to know?
Trust me when I say… this information will blow your mind!
What Dr. Brown shares is not widely known, but is absolutely critical for this community.
Please watch… here’s just a taste of what we cover:
- How the research shows the gut plays a MAJOR role in this pandemic (Dr. Brown has spent the past 2 days reading pre-publication research)
- 30+% of people with Covid-19 have GI symptoms – and why those who do have WORSE outcomes
- What you need to know about ACE2 receptors, high cholesterol, high blood pressure, and increased risk
- Should you hold off on SIBO treatment right now?
- Dr. Brown’s recommended supplements (and WHY you should use each one)
- Why Dr. Brown has all his front-line hospital employees taking Atrantil right now
Dr. Brown has also offered our community a huge discount on Atrantil… up to 38% off and FREE 2-Day Shipping.
This is the lowest price on Atrantil available anywhere… and orders are shipping out now!
Here are links to some of the products and resources mentioned in our interview:
Atrantil discount and 2 day free shipping!
Megaspore from Microbiome Labs (Get 15% off your first order with code DIGESTIONSOS at checkout – must register as a patient with Patient Direct Code SIBOSOS)
Shivan Sarna: Hi, everybody. Welcome to SIBO SOS®. I’m Shivan Sarna. I am here with Dr. Kenneth Brown, double board certified internal medicine physician and gastroenterologist.
He is an incredible healer. He has an extraordinarily busy practice. He takes the information that he experiences every day with his patients along with the research like from Dr. Mark Pimentel and all these brain trusts that he’s friends with. And he reads and reviews their research and then applies it in the clinic. And he then often shares his experiences in the clinic with his friends or the researchers. It’s a beautiful thing!
You may know his work from being the one who created Atrantil, the only clinically found supplement to impact bloating that is all natural and is a fascinating series of compounds—which we’re going to talk about.
The purpose of this is to educate everyone about Covid19. And he has compiled a huge list (along with his grad students) of studies about the impact on people like us who have gut issues, along with anyone who’s on the planet breathing. And we’re praying for all of everybody that they continue to breathe with ease and grace and health.
I think everyone needs to hear this, whether they have a gut issue or not.
It’s a pleasure to have you here, Dr. Brown. Thank you so much for spending some of your valuable time with us today at SIBO SOS®.
Dr. Ken Brown: Hey, Shivan, thank you so much. I mean, first of all, thank you for taking the time to do this. Thank you for reaching out to your people, your tribe. Your team has been amazing. You guys are continually trying to do this when we first set this up. Of course, it was pre-SARS-CoV-2/Covid. And now we all had to pivot. The whole world has to pivot and change. And we’re going to do that same thing.
And so, right before everybody got on, I had to run to the restroom really quick because I’ve spent all day looking at data, looking at research, doing different things. We’re all changing hour by hour. And as a gastroenterologist, I feel a moral obligation to make sure that we discuss gut health and immune health because that’s where we’re at right now.
And this is not going to be a big, heavy—what would I say? Normally, you and I would talk about my product a whole lot. I want to talk about disease states. I want to talk about what’s going on. And I know that I’m wearing the scrubs. But that’s just kind of the standard. This is what I wear to work. But I want to go wherever this wants to go. But I’ve got so much information to share—like how ACE2 receptor that’s in the lung is actually in the gut, and how over 48%, or now we’re learning that 48—I’ll take that back, 30% to 48% of people contract this through their gut, and they have gastrointestinal symptoms. I’m going to blow your mind on this one.
I’ve been reading studies, it’s been crazy. I’ve got studies showing that we have viral shedding through your feces five weeks after they have viral shedding in the lungs.
So, why I’m so excited to talk to you is because the gut plays such a role in this pandemic and nobody’s talking about it. And this is not my opinion. This is just study after study that I’ve just been trying to digest. A lot of it is happening from what we’ve learned in China. We’re just starting to get some data.
Dr. Ken Brown: I have this incredible graduate student who is a patient of mine. She is a nurse. She went on to get her certified nutrition degree. And her and I collaborate all the time. Her name is Angie Kirk. And I want to have a shoutout to her…She is amazing! This is a list that she has compiled for me in our Mendeley account called coronavirus related to some sort of GI thing or related to polyphenols and different things.
Shivan Sarna: What’s a polyphenol before we move on because it’s so basically important.
Dr. Ken Brown: A polyphenol is what makes vegetables colorful. But Shivan, the stuff that I got will blow your mind.
Shivan Sarna: Okay, bring it on!
Dr. Ken Brown: It’s so funny how you go from, “Oh, I’ve got this really good job. I’ve got a couple companies” to “We have to save lives!” I mean, we can’t just sit here and panic. What started out about SIBO, everybody that has SIBO, you’re at risk. Let’s start with that. We need to fix that. Everybody else that doesn’t have SIBO… we’ve got some really cool things.
So, it’s a dark period that I’m going to tell you about how many people are being affected and then I’m going to end with the fact that there is hope. And research.
The problem is these are stressful times. I don’t want to make it more stressful. We know that if you can reduce your stress mentally, physically, any way you can do it, we know that stress affects the gut. There’s the brain-gut access. And if we can help your audience learn how to do that, then we will protect our first line of defense… which is the gut.
Shivan Sarna: Share with us some practical solutions and tell us about some of the evidence. First and foremost, when I hear you say that, if someone has small intestine bacterial overgrowth—which is the number one underlying cause of IBS (and I’m going to cover a couple of definitions that half the audience already well knows because I’m hoping to really get this to a huge audience of people who are not really overly familiar with this gut condition)—if you have an issue with your gut, maybe it’s diverticulitis, it’s H. pylori, it’s constipation, you don’t know why, what is it that we need to be doing to help us to reduce our risk of exposure and maybe a little bit about the mechanism about why.
They say all disease begins in the gut… therefore, all healing begins in the gut. But why is that gut connection so particularly important. And we don’t need to get into this, but the other part of my brain is like, “And why is no one talking about it?”
Dr. Ken Brown: Oh, I shouldn’t be touching my face. Sorry! Every time we get on a Zoom call, I realize how much I touch my face.
Shivan Sarna: Sit on your hands. Sit on your hands. No seriously, sit on your hands literally.
Dr. Ken Brown: All of those questions are right up there with “what is the meaning of life… why are we here?” because what you’re actually describing are very complex questions.
Shivan Sarna: Do your best.
Dr. Ken Brown: Alright, let’s see where we ‘re going.
Shivan Sarna: Bring it on! Bring it on.
Dr. Ken Brown: Well, I’m going to start with this. We now realize that 30% to 48% of people diagnosed with Covid19 have gastrointestinal symptoms. This is something fairly new that we did not realize. And now China is publishing data. Here’s something really scary, those that present with gastrointestinal symptoms, 28% being diarrhea, they have a worse outcome.
So, we know that if you contract this virus through your gut, you have a higher likelihood of having a bad outcome.
I’m talking about cutting-edge stuff, I’ve spent the last two days reading pre-publication research because my graduate student is able to find things that nobody else can find.
So, what I’m talking about is all backed by science. It’s all backed by studies. I am so passionate about this that I feel like everything that we’ve done has led up to this where I feel like we can change things.
Shivan Sarna: Okay. Bring it on in terms of everyone’s wanting to know how can we get it more easily than somebody else?
Dr. Ken Brown: It appears that the virus binds to what is called an angiotensin-converting enzyme 2 (ACE2) receptor. ACE2 receptors are predominantly in the lung, stomach and duodenum. They’re the most common places where these are on the cells.
So, if the ACE2 receptor is there, and if the virus is taken in orally, then it will bind to the ACE2 receptor.
If you happen to have underlying conditions like hypercholesterolemia or you have high cholesterol, you will have more ACE2 receptors because, as it turns out, they get up-regulated with two things—high blood pressure and high cholesterol.
Now, high cholesterol is something nobody’s talking about because we found an article that talked about lipid rafts. And what that means is that the virus, when it binds to the ACE2 receptor, has to be taken into the cell so that it can replicate.
Those people that have these co-morbid conditions, meaning that if you have underlying diseases like hypertension, hyperlipidemia, and diabetes, you are more likely to get infected because it’s easy to get there.
As it turns out, the stomach and duodenum have equal amounts, or at least we think, of ACE receptors as the lungs. So people have completely forgotten that the gut is there.
Now, the reason why I am really aggressive treating my SIBO patients and warning them about this—washing hands, cautious about eating out and all these other things—is because we know that SIBO actually will produce a protein zonulin which will create a leaky gut. So, if you have intestinal permeability and leaky gut, that will allow easier entrance of this virus.
In addition to that, what will happen is that your immune system gets turned on. When your immune system gets turned on, it’s fighting SIBO which allows the virus to come in the back door.
That’s why it’s so relevant that you’re doing this particular thing. And we talked about trying to incorporate this—not only is it so easy to incorporate, it’s completely relevant, absolutely relevant, that we discuss this. Your gut is your first line of defense. You’re always taking in the outside environment. And as you’re taking the outside environment, then you have to be able to defend it. And if your gut is already compromised, I’m worried about my SIBO people, I’m worried about my IBD people, and I’m worried about all these things.
Shivan Sarna: So, what are some of the things that we can do? Maybe some people have some Allimed at home—which is the garlic, allicin extract. A lot of people I think have some DIY herbs at home that they can maybe pull out and start treating their SIBO. Does that make you more vulnerable? What about die-off?
What is it in polyphenols (which could you define for me please)? How is that impacting people who are trying to fight the virus—which is everybody?
Dr. Ken Brown: Before we end this, I will give you my gastroenterologist’s take on what supplements to do for this.
Shivan Sarna: Great! Okay, great.
Dr. Ken Brown: Okay, knowing that your first line of defense is your gut, let’s talk about something that is really important that everybody has. You need to take in zinc.
Zinc is a mineral that is really important for your immunity. What people don’t understand is, when you take an oral zinc—we know that zinc lozenges and things like that have antiviral activity. Nobody’s really talking about why. Let’s talk about why really quick.
Dr. Ken Brown: As it turns out, zinc has to be absorbed into the cell. Once it’s absorbed into the cell, it becomes intracellular zinc. Taking zinc doesn’t necessarily mean that you’re going to get it in the cell. To get it in the cell, you need something called an ionaphore, a vessel that allows something to get through.
So, the cell is impermeable to standard zinc. It needs something to help it, which in philosophy, is very common because you always need some transporter to get it in.
Now, let’s shift gears and talk about polyphenols. Polyphenols are these complex, beautiful molecules that make vegetables colorful. It’s what makes fruits and vegetables colorful. It is the most prominent thing in the Mediterranean diet.
So, that being said… holy cow, I found a study that shows the polyphenols work as an ionaphore, meaning they drive zinc into the cells. So then you go, “Well, what does that do?”
What zinc does when it’s intracellular, it turns off the RNA polymerase enzyme in SARS-CoV2.
Just to clarify for everybody… it’s impossible not to make this just a total Covid-type thing. Covid is the disease. Covid19 is the disease. SARS-CoV2 is the virus. Corona is the family of viruses. I believe that one of the problems from the very beginning was the media described it as the “coronavirus.” They did not differentiate that it was a novel coronavirus. What that means is corona is the family. SARS-CoV2 is this new, super virulent virus. It is a thousand times more infectious than SARS-2003. And the way that people are dying is 1) the way that the influenza kills us which is it attacks the lungs and 2) it has a similar effect as the Spanish Flu of 1918 which creates a cytokine storm.
This is no joke. I’m extremely passionate about this right now. I’m going to make sure that everyone is informed.
So, SARS-CoV2, when I say that, we’re talking about the virus. When I say Covid19, that’s after you’ve been infected—very similar when it was HIV or AIDS.
Shivan Sarna: Got it!
Dr. Ken Brown: Okay. So, what we know is that when zinc is in the cell, if the virus can get into the cell, zinc blocks the enzyme that allows it to reproduce or allows it. So, the virus gets in the cell, and it goes into the ribosome (which is where the cell does this), and then it hijacks the cell. As far as the parasite, it is the most fantastic parasite. This particular virus takes over your cells. That’s what ends up happening.
So, long-winded explanation of why you need intracellular zinc, one way to get it is to eat polyphenols. Have a colorful plate… very colorful plate.
We know that the molecules in Atrantil are polyphenols. But I don’t really want to talk about that. I want to talk about how to prevent getting this, how to make sure that you protect your immune system. And so I hope you don’t mind that we’re going to get a little off topic of SIBO.
Shivan Sarna: Oh, my gosh, no! This is a holistic conversation.
Dr. Ken Brown: Okay, cool.
Shivan Sarna: This is holistic, okay? We’re mind, we’re body, we’re spirit, we’re gut, we’re lungs… we’re everything.
Let’s say we were to take a supplement of zinc—because I know a lot of people have little bottles of zinc at home. They have like the Cold-EEZE lozenges and that kind of thing), is there a particular form if they were doing it in isolation that would help?
Dr. Ken Brown: Wow! I am not an expert in that. I know that I did a Summit interview yesterday. And I think they had multiple experts discussing the difference between zinc gluconate, zinc glycinate, whatever. I will just say that my bandwidth is only so big.
Shivan Sarna: No, I don’t expect you to know everything. Oh, my gosh, no! I’m just wondering.
But we’ll move on because if it’s a polyphenol, if it’s your veggies, I think, yes, vitamin C in high doses is amazing. Vitamin C in an orange, we’ve always been told is more bioavailable. But you can’t eat a hundred oranges. So it’s just something to think about, getting it from a food source.
Dr. Ken Brown: Yeah, the short of it is, in case everybody has something to do—and this was repeated by the experts on the summit panel as well—what I’m doing and what I’m telling my patients to do is vitamin C, vitamin D, melatonin, n-acetylcysteine, Atrantil for gut health and… let me check my notes real quick.
Shivan Sarna: What do you think about quercetin?
Dr. Ken Brown: Oh, my! The thing about quercetin has been studied a whole lot. Quercetin is a polyphenol that is the one. So quercetin luteolin and turmeric are polyphenols that get studied all the time. They get studied all the time because they’ve already been studied.
The thing about it is that I’ve got data to show that the proanthocyanidins (which are large polyphenols), they all have similar antiviral, antibacterial, and antifungal effects.
I mean, you’re going to have to prevent me from geeking out completely, but we can get into all of this. I’ve got study after study after study that I’ve been diving deep because I had no idea how much scientists, after the SARS-2003 outbreak, became an obsession of theirs to look at—they’re much more open to natural treatments.
Shivan, it’s crazy! I think we’re sitting on something that we can help naturally. We don’t need to just run immediately trying to find like hardcore drugs and stuff. I think we can actually mitigate this with diet and a few supplements.
So yes, quercetin has been studied. Quercetin has been studied in the binding of the virus. Studies have shown that it is effective in preventing the binding. It has been shown that it is protective in driving the zinc into the cell.
So, what you’re saying is it’s like saying lemon versus orange when we talk polyphenols. They’re citrus fruits. They’re complex, beautiful molecules.
The biggest thing is when we’re talking to everyone that’s watching this, we need to have a healthy diet. And we need to make sure it’s a very colorful plate.
Now, one of the problems with SIBO people is that I have found that many of them take out some of these amazing foods out of their diet. And if you’re doing that, if you’re on a FODMAP diet, if you’re on an SCD diet, if you’re on an elemental diet, you need to feed your microbiome. You need to make sure that you can fight this thing. Those are the people that I worry about.
I was thinking about it. I talked to some Crohn’s patients and ulcerative colitis patients. And then, I started thinking, “You know, the people I’m most worried about are my SIBO people because they’re so limited in their diet. And they’re very obsessed about trying to control that.”
So, we need to make sure that that gets expanded.
Shivan Sarna: Absolutely!
Okay, one more time from the top, the alphabet of the supplements and the vitamins that you were talking about.
Dr. Ken Brown: My gastroenterology recommendations based on science—
First of all, I’m a fan of fermented foods. As it turns out, if there is a Lactobacillus plantarum or bifidobacterium, then it has been shown to be protective there.
So, probiotics in the SIBO population, I try and steer people away. I know that maybe the fermented foods. But I’m going to ask you to start doing some sauerkraut.
If you look at the data right now, Germany has one of the lowest death rates from Covid19. Why? I don’t know. Is it the beer? Is it the sauerkraut? Who knows! But we’re going to learn all this as a world. For the first time ever, the world is collaborating. People are putting science out minute by minute. Every time I wake up, I end up with 100 new articles I need to deal.
Zinc… if you are low, your immune cells will not function as well. So we need to get it intracellular. So take a polyphenol. My suggestion is a polyphenol supplement that will block that can actually drive it intracellular. This will block the enzyme that allows the virus to replicate. This has been shown in multiple studies. My recommendation is 25 mg. a day. If you take too much, then you can deplete your copper and a few other things can actually happen.
Vitamin C, everybody’s talking about this. It’s an essential micronutrient that will work as an antioxidant. Studies in humans are conflicting. So, what you’ll see is experts talk about how “in this study, it did this.” But what I want to talk about is the in vitro study. They have shown that it actually blocks, and it downregulates NRLP which is an inflammasome. An inflammasome turns on your cytokine storm. So I’m having all my patients take vitamin C.
So, my rationale to the human studies is that they did knockout mice in one study, and they showed that those mice that genetically could not produce vitamin C, when they inoculate the mice with the influenza virus, all the ones that did not have the ability to produce vitamin C had horrible outcomes and died; those that did had decreased inflammation and decreased inflammatory cytokines.
So, there is no joke. If most doctors are saying… well, the evidence is kind of out there. I’m looking at if there’s a mechanism of action, and the harm is very low, do it.
So, zinc, fermented foods, vitamin C…
Vitamin D… vitamin D is another one. In a systematic review, vitamin D appeared to protect individuals from acute respiratory infections. Vitamin D is expressed on all immune cells, B- and T-cells. And it can modulate the innate and adaptive immune responses.
Low levels are associated with increased autoimmunity and increased infection rates.
So, no-brainer here, vitamin D is super important. And at least 1000 mg. a day. On Chang’s report yesterday, a lot of these functional medicine doctors were talking more than that.
And then, I’m trying to encourage my patients to eat a diet high in phytosterols. And this is super wild. Phytosterols are plant molecules that look a lot like cholesterol. And there may be some evidence that it will tie up the lipid raft at the ACE2 receptor. [30:07]
Dr. Ken Brown: Evidence has been shown in vitro. These are not human clinical trials. The problem that we’re running into right now, Shivan, is that this is a novel coronavirus. This is something that has never hit us since the 1918 flu. And we’re dealing with this hour by hour. And people are gathering data.
And some researchers have shown that if you eat a lot of legumes, some grains, fruits and veggies—we keep getting that to the same thing, fruits and veggies. So the fruits and veggies may plug the ACE2 receptor so that the virus has no place to attach.
The recurring theme here is… healthy diet, healthy gut, healthy protection.
And then, n-acetylcysteine has some mucolytic properties. In a meta-analysis in 2017, they found that treating patients with n-acetylcysteine led to shorter duration stays in the ICU with ARDS patients (patients that have severe acute respiratory disease in their lungs).
And right now, Chinese hospitals are using n-acetylcysteine as a standard protocol for this. I like it a lot because what it does is it increases glutathione levels. The glutathione is a potent antioxidant, so it prevents the cytokine storm.
Alright! Fermented foods, zinc, vitamin C (reasons above), vitamin D, a diet with a lot of fruits and vegetables, nuts, n-acetylcysteine and then two more things…
Melatonin, it’s a potent antioxidant, but those researchers that are going, “Why don’t kids have a bad outcome from this? Why are kids spared?” One of the theories is that kids have a much higher melatonin level naturally than older adults.
I looked deeper into this. As it turns out, melatonin also blocks this NLRP3 inflammasome. So, kids 1 to 5 have huge levels of melatonin. And it may be that the melatonin blocks the cytokine storm. So take melatonin.
And then, the final thing which nobody seems to be talking about is something called sulforaphane. Sulforaphane, this is my new favorite thing.
Dr. Rhonda Patrick who’s a PhD that I follow occasionally, she did a lot of research on this. Cruciferous vegetables in the sprout form—not in the big plant form, in the sprout form—have super high levels of a molecule called sulforaphane.
Sulforaphane turns on a pathway called the NRF2 pathway. You don’t have to remember that. All you have to remember is this, that the NRF2 pathway is a potent modulator of inflammation and anticancer. It also crosses the blood brain barrier to decrease neuroinflammation.
So, I was listening to a lecture by a Johns Hopkins professor. It was discovered by Johns Hopkins in 1992. His group of doctors, they figured this out. Then they discovered the NRF2 pathway. And then, all of a sudden, he started talking about the antimicrobial effects of sulforaphane.
And once again, it all comes down to science. I’m willing to try a whole lot of things on people, on myself. Everything gets tried on myself first, by the way. So, in case anyone’s wondering, I’m on all this. My patients are on all this. My family’s on this. And hopefully, we are being protected here.
So, that’s my magic combo. So, one last time… fermented foods, zinc, vitamin C, vitamin D, a diet high in phytosterols (which are nuts and healthy foods… just eat healthy is what I’m basically saying), n-acetylcysteine, melatonin, and of course pages and pages and pages on the effects of how polyphenols affect this particular thing. If you do not have a healthy gut, you will be at risk. So that’s my thing. The polyphenols, you can get it in a lot of different ways, eat a lot of food.
Shivan Sarna: I have a couple of questions before we move on. So, sulforaphane… that’s like the whole broccoli seed thing? Is that correct or wrong?
Dr. Ken Brown: No, it’s wrong. So, what it is… is that sulforaphane is a molecule that is produced when you masticate. When you crush the broccoli sprout, an enzyme called myrosinase comes in and converts glucuronidase into sulforaphane.
Shivan Sarna: Cool!
Dr. Ken Brown: So, up until just now, like just recently, there’s a ton of broccoli sprout products. Johns Hopkins did a whole study where none of them had sulforaphane. A few of them have put glucuronidase with the enzyme, myrosinase, to hope that it happens. But then they realize that it’s not actually happening.
So, I was so excited when I was contacted by the CEO of this company, BrocElite. And he’s like, “We’ve got data.” I’m like, “Get me on with your scientists.” So I did a Zoom just like this. You know what?
Dr. Ken Brown: The reason why he contacted me is because his scientist discovered that our polyphenols help their product get better absorbed.
Shivan Sarna: What?!
Okay, listen, we need to know what a polyphenol is. And then, for people who have not heard you before, I want you to do a two-minute version of how you created Atrantil because this is so important. I know a lot of people don’t know that story.
But what’s a polyphenol? This is what is in wine. This is what creates colors in food, right?
Dr. Ken Brown: Polyphenols are molecules in nature that are natural. They are the molecules that make vegetables and fruits colorful. They are the molecules that are predominant in the Mediterranean diet.
The science of polyphenols is just now getting off the ground. We now realize that polyphenols are these large, beautiful molecules that our own microbiome breaks down into something called postbiotics.
Postbiotics are the anti-inflammatory, anti-aging molecules that the Mediterranean diet is.
We have been ignoring this. The three ingredients in Atrantil are cabracho (which is a very large polyphenol called a Proanthocyanidins), horse chestnut (which is also a polyphenol. Well, horse chestnut has some saponin components to it. And there are reasons why. I would discuss that), and then peppermint (not peppermint oil, but peppermint leaf, because when you get the oil, you’re taking a lot of these natural polyphenols out).
So, polyphenols are the reason why vegetables are healthy for you.
Shivan Sarna: Okay, that sums it up! That’s perfect.
Shivan Sarna: And think about, if we’re talking about color, chlorophyll is what makes plants green. Chlorophyll is so similar to human blood. This is what we’re talking about here. Why do you eat the rainbow, all of that…
Dr. Ken Brown: That’s so great! Several blogs written about just eat a rainbow every day, and you’re going to be healthy.
Shivan Sarna: Love that! You know, I’m a huge fan of veggies.
And it’s hard if you have SIBO, don’t get me wrong.
Dr. Ken Brown: Okay, so let’s just shift gears really quick and talk about SIBO really quick.
So, what I’m shifting to right now is I’m telling my patients, I’m like, “I feel like we’re doing a disservice by you eating this FODMAP diet. It makes you feel better. But we’re not increasing your microbial diversity. So Eric Rieger and I have a podcast called the Gut Check Project. We did a whole show on short chain fatty acids. And we did it specifically on how, if you have a narrow diversity, you can produce more acetate and propionate and lactate… which increases blood-brain permeability.
So, now all of a sudden, we’re starting to put the science to the symptoms. When patients come and see me, and they’re like, “I got really sick five years ago. And every time I eat, I bloat. But more importantly, I have a foggy brain. I’m anxious now. I’ve got these panic attacks.” I can tell them, “I believe that you have increased your lactate production due to a lack of microbial diversity.”
So then we need to have this hard conversation: “I’m going to ask you to be bloated for a little bit. We’re going to treat you for SIBO. But we’re going to put your ego on the shelf, and we’re going to try and get your microbial diversity broader, so that you can start producing different short chain fatty acids like butyrate, which has been shown to heal the gut, which has been shown to close these intestinal barriers, stop leaky gut, stop leaky brain.”
So, I’m telling a lot of my patients now I know. And now, six months, seven months later, they’re like, “This is the best I felt. I was miserable!” And I played the game of FODMAP, SCD… and I’ll play it while we’re trying to treat. But at some point, we’re doing more harm long-term by trying to treat your bloating than we are with trying to treat your total body.
Shivan Sarna: So, several things I got so exhausted from being on a restricted diet, especially as a vegetarian—I’m still a vegetarian happily. But I just was like, “Screw it! I’m going to be bloated.” And then, I did start to feel better.
But there is a time and a place for it. If you’re going on vacation maybe, you don’t feel like bloating. If you’ve just had a flare, you want to bring that flare down.
These are just my experiences and observations.
And then, the other thing is… everything you just said is so exciting to me because if we do look at food as medicine, then you’re going to maybe have a little bit of a side effect here and there. That’s actually a good thing because the bloating can be a side effect of the medicine you’re taking… which is eating good rainbow foods.
Dr. Ken Brown: I had a plant-based doctor on my show… super brilliant guy! And we discussed that. And he said, “I’ve been trying to integrate this with my patients.” But the problem that we as humans do, especially people that are trying to take control of their lives—and I’m it, I am the example of an extremist. If I decide to do something, it is way overboard. And I just want everybody to realize, “Hey, you can do this!”
So, right now, Shivan, after I’ve watched a few Netflix specials, I am slowly going to a whole food, plant-based diet. I’m from Nebraska. My dad was a butcher. Do you understand what this is?
Shivan Sarna: I do understand!
Dr. Ken Brown: This is a big deal. And so, I’ve decided to make sure that I have a whole food, plant-based dinner.
And then, I’m slowly realizing I don’t particularly miss meat. The first thing I did is, when I watched one of these shows, I went all out vegan, and I got all the meat substitutes and stuff… I felt miserable! I felt horrible. And then, I realized they have all these fillers…
Shivan Sarna: Yeah, the meat substitutes are really tricky. They’re not based on whole foods.
Shivan Sarna: Okay, we’re going to run out of time. And I also want to ask you about CBD because people are asking about CBD which I know you also are a huge proponent of…
Dr. Ken Brown: Huge proponent!
Shivan Sarna: …their health-positive effects or possibly preventing Covid. Let’s start with the polyphenols. And then, let’s get into the CBD. And let’s take about five minutes to do this.
Dr. Ken Brown: Alright! So, five minutes, I’m going to freak you out here. As it turns out, the polyphenols have been really looked at. And I’m just going to say the titles of the studies that I’ve been looking at because it would take three hours to get through them.
But essentially, I already talked about how the polyphenols drive zinc into the cells, how zinc blocks the mRNA polymerase that the virus uses to replicate.
So, number one, step one, you’re going to block that.
Number two, bioflavonoids. Bioflavinoids Displaying SARS-CoV Inhibition. The article looks specifically at how these bioflavonoids, which are polyphenols, actually help with that.
Number three, Overview of Severe Acute Respiratory Syndrome Protease Inhibitors. What is a protease inhibitor? This is what President Trump was talking about they’re trying to fund. Protease inhibitors are anti-HIV drugs. And now, we realize that they can probably stop SARS-CoV2. And this article looked specifically at how powerful these polyphenols are as protease inhibitors.
Another article, Identification of Polyphenols as a Novel Chemical Inhibitor of the SARS Coronavirus Helicase. It’s showing how it’s blocking that: “Small molecules targeting severe acute respiratory human coronavirus, compounds like aescin”—what is aescin? It’s horse chestnut.
Shivan Sarna: Whoa!
Dr. Ken Brown: These people are doing my research for me. Identification of Potent Covid19 Main Protease Inhibitors from Natural Polyphenols: “An in-silico strategy unveils a hope against the novel coronavirus.” These guys looked and they showed that polyphenols block the coronavirus more than the HIV drug, Nelfinavir. Yeah… this is the kind of stuff I’m dealing with right now.
My team has agreed that we’re going to give Atrantil as a prophylactic measure to every healthcare worker in my hospital. It’s going to absolutely take us to the brink of bankruptcy, like everybody else. We have a moral obligation to do this. And I was thrilled that everybody on my team agreed!
Eric Rieger who is on the team and I are trying to set up a plan to figure out how to get free Atrantil to healthcare workers. I can show you how it blocks the virus. I can show you how it prevents it from replicating. I can show you how it helps with ARDS polyphenols. You can not take Atrantil and just eat a really great diet and probably do the same thing. But my healthcare workers that are working night shift, my nurses in the ICU, my ER doctors, my anesthesiologists who are intubating people, we’re trying to develop a whole new business plan to just hand the stuff to them.
Shivan Sarna: Oh, my gosh! Thank you. Thank you.
What you guys don’t know—just real quick, what you don’t know is that I’ve been working with Ken’s marketing team for years. And they have put together the lowest price in the marketplace for us for Atrantil. You guys are getting the first dibs on it. Perfect timing!
Dr. Ken Brown: This is why I was so excited with my team to say, “I believe so strongly in this. We have to give it away to the healthcare workers at my hospital.” We can’t give it away to everybody. If you don’t take Atrantil —quercetin luteolin, turmeric… these are all other polyphenols out there.
The issue is I will send ours to one of these researchers and say, “Analyze this. Tell me what the antiviral activity is compared to these other things.” And if quercetin is better or if risperidone is better, they’re all similar, then that would be the one that I would say, “Hey, do this if you’ve got these issues.”
I just don’t want to come off as sell-y. I want to just talk science. That’s my thing.
Shivan Sarna: Totally fine! That’s what I’m here for, is to help people get the information they need and everyone can be smart and make their own decisions.
A couple of things… if you have a lower esophageal sphincter issues, GERD, whatever, and you can’t do peppermint oil, is the peppermint leaf typically found to be more easily consumed without side effects.
Dr. Ken Brown: That is a great question! And yes, usually because the capsule gets released in the duodenum which is where we want it to go for SIBO people. Some people have complained of a little bit of reflux. I’m hearing a lot less of that because a lot of this is, they read about the peppermint, they can’t take the oils and other forms, and then they see that it’s there. We chose the leaf because it has to be digested first before the oil is actually even in effect.
And I don’t even care about the peppermint for the other reasons why they’re antispasmodic. I need those polyphenols. I need that leaf to get to your small bowel.
Now, getting back to CBD…
Shivan Sarna: Okay, wait, before you do that… they want to know are you going to run out. They’re freaking out because a lot of people are already regulars with Atrantil. Are you going to run out, one? Number two, what if you have the SIBO that is more diarrhea/hydrogen dominant. Can Atrantil help you?
I know a lot of people are new. But I know we also have a lot of people that are very familiar with your work and Atrantil. And it’s typically for people with methane-dominant SIBO. Does it help with diarrhea or hydrogen dominant?
Dr. Ken Brown: So typically—it’s interesting because my research was to try and find a solution for people that had no solution. So, when I was working with Dr. Pimentel, and we were developing Xifaxan—I was in those studies. So yeah, for people that haven’t heard, really quick, I’ve been doing clinical research for many years. And I was involved. I was the leading enrolling site for the original Xifaxan study that was published in the New England Journal of Medicine. So, Mark Pimentel and I were talking. He had animal models. And I was just so fascinated by that. And then, he said one day that we will never help the bloated constipated person. I asked why. He said it’s because it’s due to a bacteria called archaebacteria that produces methane. I went, “Wow!”
And I wrote methane on the board. And then, my research manager, Brandi, came in. And she’s like, “Why do you have methane there?” I’m like, “It’s crazy! I just got off the phone with Dr. Pimentel. This is what it is.” And prior to joining me, she was helping a senator in Iowa, and they were trying to mandate that all the farmers in Nebraska and Iowa put something in the cattle feed to decrease methane.
And that’s when we started looking at these different products to do this.
So, it started out as a methane thing because that’s what was missing. And since we’ve done that, now we realize that it’s a bacteria thing, not necessarily just methane or hydrogen sulfide.
So, if you have diarrhea predominant, I still use a lot of Xifaxan in my diarrhea predominant. I use Xifaxan + Atrantil and have incredible results with my patients. So, I actually continue to do that.
The story evolves continually because then we started learning about the polyphenols. Then we started looking at anti-aging. It’s just one of those really cool things—we developed it for one thing, and now, all of a sudden, I feel like we have something that can help people in this pandemic.
Shivan Sarna: See, when good people put out a lot of efforts, and they knew you were going to be doing this mission, and then it all came together… and then, we’ve been friends for so long. It’s just a beautiful thing.
Ken, we need to wrap up in a moment. Please talk to us about your passion and why it’s so important right now in particular about CBD and this virus?
Dr. Ken Brown: Yes, thank you!
The whole thing about CBD that people don’t realize is that we all have an endocannabinoid system. In 1970 or ‘71, the Marijuana Act was put in or the Controlled Substance Act was pulled in, and then hemp was no longer used as a substance. Prior to that, we were eating CBD all the time. It was shown that a chicken fed hemp whole leaf would produce about 250 mg. of CBD.
So, since then, we have seen an uptick, a tremendous uptick, in autoimmune disease and everything. So, if anybody thinks that CBD is something that’s obscure, we were eating it all the time. We took it out of our diet. And we’ve become sicker since then.
So, the reason why I’m super passionate about this is that your endocannabinoid system is just like your gastroenterology system, your cardiovascular system, your neurologic system. It is super important. And when you, much like SIBO, go through stress, don’t sleep well, have issues… it goes out of balance. Its job is to try and keep you in balance.
So, CBD is super important right now because it mostly affects your immune system and your neurologic system. If you are stressed and not eating properly, not only is your gut out of balance, but your endocannabinoid system is out of balance.
So, what CBD does is it allows your body to produce its natural endocannabinoids to get back to balance.
There’s just as much science on this as the polyphenols I was talking about. And geek alert, the reason why I’m super into CBD is because the polyphenols allow your body to produce more of an endocannabinoid called anandamide because it blocks the enzyme that breaks it down. When you’re stressed, you produce more FAAH which is an enzyme that breaks down your own endocannabinoids. You’re literally trying to fight the world with one hand tied behind your back.
So, that’s the passion. It’s all Venn diagrams that come together.
Shivan Sarna: It’s a beautiful, beautiful lotus blossom.
Somebody’s asking about the shipping and handling. And one of the reasons why they’ve gone to Amazon—which I’m a huge fan of Amazon—to buy is because they have Amazon Prime. It’s free 2-day shipping except for—I think it’s Alaska and Hawaii.
Shivan Sarna: I know! So, continental US.
Shivan Sarna: People are wondering about Canada. Is it available in Canada?
Dr. Ken Brown: It is available in Canada. Yes, it is. And I’m going to overstep my bounds here. We’re actually on Amazon Canada. But I want to make sure that they take advantage of your code. So contact my team on that one. I’m sure that we’ve got a way to get it though. [ < link for Canadian addresses coming soon]
Dr. Ken Brown: I’m pretty proud of the fact that I started this company, and I can focus on the science right now because my team is doing an incredible job of running the business doing this. And I’m so excited to find out what happens.
Shivan Sarna: I’m very happy about everything you’re saying… except that if you have gut issues, you’re more susceptible to Covid19.
Dr. Ken Brown: Protect your gut, protect your immune system.
Shivan Sarna: “Which CBD? There’s so many fake versions out there,” from Amir.
Dr. Ken Brown: That is one of the issues. I teamed up with a company called Elixinol. And they produced a specific batch just for me that we have a certificate of analysis on.
Which CBD do you want? You want to make sure that you check the boxes. You want to make sure that you get your CBD from an organic location. You want to make sure that it’s naturally extracted with CO2. You want to make sure that it has a certificate of analysis. And you want to be able to make sure that the actual milligrams are actually there.
And so, one of the reasons why I teamed up with them is that Consumer Labs did an analysis of this. They actually contacted me, Elixinol, so that we could team up and do a physician grade CBD. One of the reasons why we did this is because they could show that they checked all those boxes. And Consumer Labs did a thing. They actually analyzed and showed that for price per milligram, it was the cheapest.
So, I had what I felt was a company that I found was the best CBD at this time for the most economical price. So that’s what I’m doing.
But remember, for everyone that’s doing this, you have to think about it as, if your endocannabinoid system is deficient in your own production of endocannabinoids…Think of it like this for everybody to hear. Let’s do it GI wise. If you’re not producing enough pancreatic enzymes to digest your food, that’s the same thing as not producing enough of your own endocannabinoids.
So, what this does, what CBD does is it allows the anandamide to hang out longer. Right now, this is what the science is showing. So, all you’re doing is getting yourself back to balance. It’s not like this crazy drug or anything like that. You’re doing what your body wants.
When we talked about how to improve your immune system—vitamin D, vitamin C, n-acetylcysteine, blah-blah-blah—they all have a mechanism of action. That’s the exact same thing that’s going on with CBD. All you’re doing is getting yourself back to balance.
Shivan Sarna: I like it.
Okay! I’ve got to ask you some rapid fire questions. You know, I always do this with you.
Dr. Ken Brown: Do it!
Shivan Sarna: So, just as quick as possible with those answers. From Carleen—we love you, Carleen: “Dr. Brown, can you comment on the nurse in Kansas City who only had a fever of 99.4, lost her sense of smell and taste, was tired, but had no typical symptoms. And there are asymptomatic young people who are Covid19 positive and don’t know it. Any ideas on how to improve that situation?”
Dr. Ken Brown: Carleen, so cool that you brought that up because I think I forgot to bring that up.
Yes, so now we’re seeing that anosmia dysgeusia—which are the medical terms for “can’t smell/can’t taste,” those two terms—appear to precede all the symptoms. So, if you end up in a situation, and you can’t smell for some reason…
So, when we were looking at data from China, they came up with—
In the American College of Gastroenterology, they talked about how 38% of the people had gastrointestinal symptoms, 49% had diarrhea. They excluded the anorexia people in China. They did a study of 200 people. And that’s where they came up with the conclusion that 48% of the people had GI issues. Those people did worse. Then they looked at that… and 86% had anorexia.
So, then I took that and looked back—and this is a week ago before people have been talking about it. My graduate student and I looked at this, we’re like, “Why would they have anorexia?” And then, she found this whole article where an ear, nose, and throat doctor said, “Hey, heads up! From the UK, I’ve diagnosed multiple Covid people, and they all presented with anosmia way before they had symptoms.”
So, the answer to her is, yes, regardless of the fever, the anosmia or the lack of smell could be the canary in the minefield.
Great question! So, she’s doing her reading. That’s cool.
Shivan Sarna: Whoa! Yes, Carleen is a student for sure. She’s amazing!
Okay! Rachel has talked about how she knows how gut health affects overall immunity. Yeah, we answered your question Rachel. That was like one of the first things we talked about.
“The antimicrobial herbs often used to treat SIBO, could they actually be helpful?” She’s thinking about Candibactin-AR which has sage, oregano and thyme.
Dr. Ken Brown: So, sage, oregano and thyme are polyphenols. So, short answer without looking at the data… yes, I did find some stuff specifically for you. A couple of studies looked at allicin from garlic—but not so much against the virus. That being said, a couple of small studies.
My encouragement is, if it’s a polyphenol, take it.
Shivan Sarna: Got it! Got it, got it.
“About how much vitamin C should we be looking at for our guts and virus right now?”
Dr. Ken Brown: Oh, that’s interesting. So, when I looked at it, I was thinking 200 to 500 mg. a day. Dr. Lundqvist was on the summit with me and he does a lot of IV infusions. Keep in mind that China right now is doing IV infusions of like 24,000 mg. IV. So, what he recommended—and I will go with him because he’s done his homework on this—is 1000 mg. a day.
The problem with taking too much is it will create diarrhea, and you’ll pee it out. But not taking enough…
So, I was erring on the side of 200 to 500 mg. And then, he said that the body can handle thousands and thousands of milligrams. That was a whole Covid thing. They just brought an expert in each field to discuss Covid treatment—1000 milligrams I guess. Split it up though because you can create a significant amount of diarrhea if it doesn’t get absorbed. It works like an osmotic laxative.
Shivan Sarna: That could be good for a lot of people (depending on your SIBO situation).
Dr. Ken Brown: A lot of people do take high dose vitamin C to go to the bathroom.
Shivan Sarna: Right!
“Do you need copper to absorb zinc?”
Dr. Ken Brown: No, but too much zinc can lower your copper.
Shivan Sarna: Oh, interesting.
So Jen is saying that she’s heard—“heard,” there’s a lot of that going on right now—that someone said that if they take turmeric, it can possibly increase the cytokine storm.
And can you define what that is? People are throwing that term around like it’s confetti.
Dr. Ken Brown: Yeah, so cytokine storm is this. When you think of it like this, it’s your body’s over-reaction to the invasion. So, the virus comes in, a virus. Now, we’re talking cytokine storm with Covid19.
It can happen when you have SIBO, leaky gut and your body overreacts to the situation that leads to autoimmune disease. That’s not a cytokine storm. That’s a cytokine season.
Cytokine storm is when your body overreacts greatly to it and releases all these cytokines. And cytokines are released from white blood cells and T-cells to try and kill it, but it’s so much that it overwhelms the body, and you end up having organ failure from your body essentially overreacting to it.
So, the cytokine storm, the Spanish Flu of 1918 was so deadly, 18- to 25-year old’s died in that one because of the cytokine storm. What makes this Covid19 horrible is that there is a percentage of people that have the lung issue where it destroys surfactant and then they can’t breathe. And then, there’s a percentage of people that have the cytokine storm.
So, what is causing it… we don’t know.
Now, regarding turmeric, I have not seen any scholarly articles related to that. We do know that turmeric and curcumin is a polyphenol that, generally speaking, your body does very well with. The absorption is quite poor. So it’s your microbiome that breaks it down into beneficial things.
I have not seen articles on that creating increased cytokine storm. But theoretically, the cytokine storm is an individual-to-individual thing. That’s what I’m thinking.
Shivan Sarna: Okay.
“Can you take Atrantil if you have colitis?”
Dr. Ken Brown: 100%… all my colitis patients are on this. And the reason is because it does help. My combo for colitis and Crohn’s… Atrantil + CBD. And now I’m adding the BrocElite. That’s my three-combo thing. I can give science to it as to why I like all three.
Shivan Sarna: …which is what you talked about in this session.
BrocElite… does that contribute to hydrogen sulfide SIBO?”
Dr. Ken Brown: I have not looked at that. I’ll be honest. I haven’t even thought about that. I do seem to have successful results combining them because it does have antimicrobial properties. I will look more into that.
Shivan Sarna: Cool! Cool, cool, cool.
Dr. Ken Brown: Remember, if you’re a nurse or a doctor working shift work, not getting good sleep, and you’re taking care of—I mean, look at our New York doctors or our Italian doctors. These guys are our heroes, total heroes.
Shivan Sarna: Anybody in the medical profession right now, thank you.
Dr. Ken Brown: I mean, you have the guts to show up to work and be lacking sleep and tired and all this and wear masks…?
Shivan Sarna: …with bruises!
Dr. Ken Brown: I’ve seen pictures of Korean nurses where they’re getting scars from the mask!
Shivan Sarna: Ugh!
Dr. Ken Brown: You know what? They’re the heroes. That’s awesome. And if I can protect them, then we’re going to do that.
So, once Eric and I come up with that, what we will do on the front page is going to be this summary—brief summary, not geeky summary like I’m doing with you. It’s just “it does this, does this, does this…” The back page is going to be a whole reference page. So, we’ll get that to you and your tribe.
Shivan Sarna: Okay!
“Healthcare workers, what is the dosage of Atrantil for healthcare workers?” or someone who’s really looking to boost versus the two to three times a day on the bottle?
Dr. Ken Brown: Yeah, that is a great question. And my team actually asked me that. And we don’t really know. But if I’m using logic and I’m looking at this, I think that frequency is more important than dosing.
So, if I’m going to do this, then I’m going to take it frequently just in case I get exposed.
So, one of the things I say and that I’m telling all my patients is we’re now in a time where people get a little cooped up in their homes, and they want to go and dabble in that takeout, the person making your food, there is a fecal-oral route of getting this. If you’re going to eat any food that you’re bringing into your home that you did not cook yourself, that you did not wash your hands for 20 seconds before doing it, then definitely take Atrantil.
I’ve been on at least 6 tablets to 10 tablets a day now for five years. And I got my blood work checked. I’ve done this. At least in me, it has been beneficial.
So, for everybody else, I would say maybe one tablet three times a day just so that it’s there.
Shivan Sarna: You don’t have to build up to the whole bottle. That’s not what you meant. But just keep a baseline… that’s what you’re saying.
Dr. Ken Brown: The deal is, if you get exposed, you want to hit it.
Oh, in fact, vitamin D, they showed in the studies that sometimes we treat people with vitamin D with like 50,000 units once a week, that was not beneficial in preventing viral illness. Taking it daily was beneficial… which shows that it has that innate immune effect. And that’s how I’m kind of viewing this also. Take it on a regular basis.
Dr. Ken Brown: Oh! Yes, yes, yes! My man, Kiran! So, in our subscription box, that’s what I have.
I interviewed Kiran Krishnan, the CEO of Megaspore. And we geeked out on the fact that Megaspore as a sporebiotic uses these polyphenols to wake up when it gets to the colon. And then, it sends its signaling out. So, not only can you take it, we’re trying to figure out how to combine…
Anyways, I won’t get into that. That’s a business thing. But I love the combo!
Shivan Sarna: One more question, Shannon: “What can I do while lactating and treating my SIBO?”
Dr. Ken Brown: Short medical-legal answer is I can’t recommend anything.
Shivan Sarna: Okay.
Dr. Ken Brown: And I hate to say that, Shannon. I’m just sorry. It’s just that, unless something has been studied in pregnancy or in lactation—meaning that you pay to see. And one day, I hope that we have enough money in Atrantil to do those studies. But it’s extremely expensive. So, hopefully, we will be able to tell you that we can actually do that.
Shivan Sarna: …that we’ve done a study on it, yeah.
Okay. You know, Shannon, I just want to let you know that there’s a Dr. Stephanie Hayes who I interviewed for the SIBO SOS® summits. She’s out of Portland, Oregon. I don’t know if she does telemedicine. But she definitely is someone who I would reach out to to see if she does do telemedicine now. We have so many people now doing it. She specializes in the kind of question that you’re asking.
Dr. Ken Brown: Oh, that’s cool. Stephanie Hayes is her name? I’d love to connect with her because I feel bad saying we haven’t done the studies, so I can’t answer. But that is essentially what I have to say.
Shivan Sarna: She’s the one who told me about how her observations were that when people cleared SIBO and had infertility previously, they were able to conceive.
Dr. Ken Brown: Oh! Oh, okay. Let’s talk about that really quick.
So, when I did the original Xifaxan study, one of the reasons why I lost a lot of patients from the study is that Brandi and I ended up losing patience in the study because they got pregnant during it. And every single one of them had been through fertility treatment and all that!
So, I was upset because we lost funding because the patient had to drop out. They were thrilled. We treated their SIBO… and they got pregnant!.
Dr. Ken Brown: That becomes an intention to treat analysis which means that they are considered a failure. And in my mind, there was a win.
Now, the person that developed Atrantil with me and Brandi, she took it the whole time she was breastfeeding. So if she wants, if Shannon wants to talk to Brandi, she can do that. But as a doctor, I got to say we can’t recommend that.
Shivan Sarna: Okay.
Anonymous: “Why do I bring up clear mucus from my throat several times a day. I have bloating. I’m a veggie. I’m on FODMAP and IBS diets. Also, what is it/where is it that I can find a SIBO diet?”
Well, SIBO diet, you can go to SIBOinfo.com, SIBO Specific Food Guide, they’re created by Dr. Allison Siebecker is my go-to; Kristy Regan’s books on Amazon about the SIBO diets.
And then, Shivan Sarna, Random House, thank you very much… coming out next year, my book. And my diet in that is based on their work, based on Dr. Siebecker’s work. And it is vegetarian.
Here’s the deal, guys. You can always add the protein of your choice. If you’re a veggie, it’s much harder as we know. Therefore, I’m like, “Why would I do something that is easy? Or some people have done a beautiful job with it and I don’t want to reinvent their wheel.” So that’s what I did.
That’s coming out. I know it doesn’t help you right this second.
But also Dr. Nirala Jacobi out of Australia who has created the Biphasic SBIO diet based on Dr. Allison Siebecker’s SIBO Specific Food Guide, there is a vegetarian version of that. And you can also check out Rebecca Coomes, The Healthy Gut. She’s also out of Australia and has cookbooks. And I think she has her vegetarian cookbook out now too.
Okay! So, what about this mucous, coughing up clear mucus from the throat several times a day?
Dr. Ken Brown: So, keep in mind that there’s a couple of things that could relate to that.
Number one, post-nasal drip. So, post-nasal drip, when your immune system is inflamed, your histamine goes up. And if the histamine is there, then you’re going to have post-nasal drip.
Number two, if you have bloating, your small intestine distends, tells your stomach not to empty, which can lead to reflux, specifically nighttime reflux that you’re unaware of (which can also lead to post-nasal drip).
Number three, if you happen to have SIBO, there’s a high correlation of SIBO with mast cell destabilization, meaning that you’re going to produce more histamine in your body when you eat certain foods.
So, all three of those things can actually lead to that—two of them are in the gut, one of them is going to be more of an allergic-type thing. So that’s how I treat my people with mucus.
Dr. Ken Brown: Really quick (because you’re going to go off to a meditation thing), the other thing we talked about supplements, but let’s talk about lifestyle… absolutely! I mean, mindfulness meditation is what I try and practice. Make sure everyone sleeps. Get rid of toxic relationships.
Now is the time to re-evaluate and practice self-healing.
So, I love that you’re going to go do a meditation class right now.
Shivan Sarna: Well, I’ve been a yoga teacher for many, many years. I’ve been on the spiritual path a long time. I don’t know what I would do without it. But that’s me.
And there’s so many cool meditations… Oprah and Deepak are doing their meditation program for free right now. Also, Self-Realization Fellowship, SRF.org I think, they have free online live meditations three times a day that you can just, through Zoom, go and meditate with them. And they also have a great site that teaches you how to meditate.
So, what is it Headspace?
Dr. Ken Brown: Headspace.
Dr. Ken Brown: Oh, you know what? For everyone, I’m a huge fan of Brain.fm. That’s another little life hack, Brain.fm. I do that to go to sleep. And I do that when I want to focus. So check it out!
It essentially uses something called neural phase locking where they play music, but in the background of the music, it’s set at a certain frequency. These are all things that I’ve talked to their PhDs about. Kevin Woods is their PhD, and I just went, “Okay, I get it! You’re super smart. I’m just going to do what you say.”
What it does is they’ve shown through functional MRIs with this science that, when a certain frequency is going in here and a certain frequency in this ear—it has to be headphones—your brain will adjust. And you can adjust it to where you need it.
So, if you need to go and stimulate the amygdala for emotion and calm down, if you need to stimulate the cerebrum and increase focus, they can do that.
And I do it, my kids do it. I just think it’s really cool. And I do Headspace. I tried it in the sauna. And I will do my mindfulness meditation with that. And then, when I wake up in the morning, I turn on my Focus Brain FM. When I go to bed at night, I turn on my Sleep FM and I drift off.
So, sleep… take care of your brain. Love one another. Don’t hug! Fist bump, elbow bump, whatever it is that you’re going to do, yeah.
Shivan Sarna: We love you! Thank you so much sir. I appreciate you!
Dr. Ken Brown: Absolutely! Thank you for doing this, Shivan.
Shivan Sarna: Oh, yeah. It’s my pleasure.
More from Dr. Brown in the near future. When the smoke clears, we’d love to get you on to talk about CBD and what that means.
Look for an email guys! The lowest price in the marketplace right now for Atrantil is through the links that
Yes, I get a little bit of a commission from it. And you know what that does? It pays people like Clarissa who’s behind-the-scenes. It pays Cyndi who makes sure that the tech is going to work for SIBO SOS®. It pays for Mariel who helps me with my copy. It helps with Lisa who makes sure that we’re all doing our jobs… because if I wanted to reach as many people as I am reaching right now, I cannot professionally do it alone. I could hack at it, and it would not be perceived or received as well because it would not be as professional (even though I’m very casual at the same time).
So, I do have a team. I have to pay them. They deserve every single cent. And I’m also very happy to be able to employ people in this marketplace at this time and economy.
So, support your local restaurants with gift certificates and the like; pre-advanced, buy some massages (so that your massage therapists can continue to feed her family or his family)… you get the idea.
We love you! Namaste. Thanks Dr. Brown.
Dr. Ken Brown: Bye Shivan. Thank you so much.
Shivan Sarna: Bye bye. Thank you.
Links above are affiliate links which means I earn a few dollars from each sale if you use my link which supports this and future projects to ensure you have access to the expert’s latest research.
Today I’m excited to share with you an all-new FREE webinar with my friend, colleague and founder of Microbiome Labs, microbiologist Kiran Krishnan!
Kiran is a fan-favorite here at SIBO SOS® and he is back by popular demand to talk about a “controversial topic” – stool tests!
If you’ve been confused or overwhelmed by stool tests, you don’t want to miss this Q&A. We’ll cover:
- What stool tests can and can’t diagnose (SIBO, parasites, gut imbalances and more)
- The problem with many stool tests
- A new approach to stool testing (available directly to patients)
This is the very first time Kiran has spoken publicly about Microbiome Labs’ new stool test- and for the first time, it’s available directly to the SIBO SOS® community!
You can view sample test results by clicking HERE.
Want to order your BiomeFX test?
Normally, you would need to order this test through a practitioner.
But Kiran has agreed to make the test available directly to the SIBO SOS® Community! That means you can order it yourself, and get the results delivered straight to you. (I do recommend working with a practitioner to help interpret the results.)
First, register as a patient with patient direct code “SIBOSOS” HERE: https://sibosos.com/microbiome-labs (This is the first step and it is essential to be able to order.)
Then, watch the below video to learn how to order and what to do once you place your order to successfully complete your test. (Having trouble? Please contact Microbiome Labs directly for help with ordering: https://microbiomelabs.com/contact/ or call 904-940-2208). (My customer service team cannot assist you with ordering!)
Since I was diagnosed with SIBO in 2015, I have been blessed to meet many talented practitioners to answer my questions, including Dr. Steven Sandberg-Lewis. I like to call him the teacher’s teacher. He has taught so many incredible practitioners and is a gifted clinician himself.
Dr. Sandberg-Lewis (or Dr. SSL as he is affectionately called by many of his patients and colleagues!) is an expert in functional gastroenterology – he quite literally wrote the book on this topic! This means that he looks at digestive issues like SIBO, acid reflux, and IBS as part of the whole body (not just isolated issues). He has been instrumental in my own healing and that of thousands of other people.
Last month, Dr. Sandberg-Lewis graciously agreed to take time out of his busy practice, Hive Mind Medicine, in Portland, OR to answer some of our community questions. The SIBO SOS® community has been blessed with his teachings in every single summit we have done! He always provides incredible insight and advice.
In this Q&A (and trasncripts as our gift to you) he covered:
- adrenal and thyroid health
- acid reflux causes and solutions
- prostate inflammation
- heavy metal poisoning
- breath test interpretation
- and much more!
There is so much information packed into this Q&A – don’t miss it!
Dr. Sandberg-Lewis is currently accepting new patients at Hive Mind Medicine! Click HERE for more information.
You can watch the Q&A below or CLICK HERE to download the complete transcript.
What do people with Small Intestine Bacterial Overgrowth want for the holidays?
You might think I’m joking… but I’m not!
While a home breath test isn’t the “sexiest” gift of all time, for someone who has SIBO, it’s a very welcome one!
And if you’ve got SIBO but are buying for those who don’t? There are some great gifts here for even those without SIBO!
(And one last thing…. I won’t tell if you pick up some of these gifts just for yourself!!)
I have an insatiable appetite for new health information… and when I find a resource that has information I haven’t heard before? Goldmine! This Encyclopedia has over 200+ uncommon but scientifically-validated breakthroughs for everything from cancer to hair loss! The perfect gift for anyone with an interest in “outside-the-box” health information. Get it here.
This skincare line is created by the brilliant Dr. Christine Schaffner (who you may have seen in the Digestion SOS™ Docuseries). It’s one of the rare skincare lines that is both totally safe and natural… but actually works! I recommend the Basics Bundle – luxe + luminate + correct. It has everything you need – and when you buy a bundle, you’ll get a free Brightening Peptide Serum (give it away or keep it for yourself!). Check it out here.
As much as I know water is good for me.. I get bored drinking it plain. I’m always searching for new ways to mix it up that aren’t full of scary ingredients like artificial colors and sweeteners… that’s how I found Pique Tea. Pique Tea is convenient pouches of tea that dissolve instantly in water – and contains 12x the antioxidants of regular tea (so good for gut health!). Did I mention it’s delicious? I recommend anything in the Holiday Favorites Collection (and use this link and code HOLIDAY10 for 10% off your order!)
What’s a better gift than a good night’s sleep? I’ve tried everything – melatonin, warm tea before bed, blue-blocking glasses – but nothing else compares to how Wholetones 2Sleep helps me fall asleep quickly and stay asleep soundly. It’s a one-of-a-kind speaker that plays noise at a specific frequency to help you sleep. Totally natural, safe, and non-habit forming. A great gift for anyone on your list! And it’s 25% off right now, to boot! Get it 25% off here.
You know how getting a really nice pair of socks as a gift is the best? (Since you wouldn’t normally splurge on them for yourself.) It’s the same with really great supplements. Science Naturals Supplements Turmeric with BioPerine is the “cream of the crop” when it comes to anti-inflammatory turmeric – and it’s specifically formulated for maximum absorption. Get 3 bottles free when you buy 1 during their Thanksgiving sale (perfect for gifting!)
Truthfully I’d like anything from Activation Products as a gift! They create luxe health supplements (including Ease Magnesium Spray which I love) and dietary supplement oils. Every item is thoughtfully designed for maximum benefits – and the packaging is gorgeous, too! Check it out here.
This is my gift to you! On December 14th, I’m hosting an Encore Presentation of the Summit with 20 expert-taught SIBO SOS Masterclasses – totally free to watch! We have experts like Dr. Allison Siebecker, Dr. Mark Pimentel, and Dr. Steven Sandberg-Lewis (and many more) on topics from treatment, testing, prevention, mold, parasites, yeast, and more! As part of my community, you’re getting FREE access – keep an eye on your inbox for more information. Not on our email list? Go ahead and register here.
Hope & hugs,
Our liver is our most overworked and underrated organ.
It’s always had a “tough job” of cleaning up the messes in our bodies… but in the modern environment, the liver often has to work overtime!
The world is a very different place today than it was even when my parents were kids…
- More air, water, and soil pollution
- Contamination in food, household, and beauty items
- Prescriptions meds contaminating our water
- Ultra-processed foods have become the norm
But it’s not all doom and gloom!
Luckily, our liver is specially designed to help clean up this mess! But what happens when the liver is overburdened? That’s what I want to talk about today.
Why I Love My Liver
Your liver is the largest internal organ (weighing in at about 3 pounds) — and the reason it’s so big is because it’s involved in over 500 bodily functions.
The liver is the “filtration” system for your body. Blood from the digestive tract filters through the liver. The liver also detoxes anything you’ve ingested that could be toxic – pesticide residue, alcohol, medication, and more.
And the liver has other jobs too – it also creates bile (which is stored and concentrated in the gallbladder) and makes proteins that are important throughout the body.
You can’t live without a liver and it’s the 2nd most common transplanted organ (right behind kidneys).
The Modern World Doesn’t Love Your Liver
There have always been toxins that needed to be filtered out by the liver – but never to the extent we see today, according to Dr. Gurevich.
“If we lived back before technology and back before processed foods, the liver would have to be processing some of “this and some of that” but not nearly the degree that it’s processing right now,” she told me.
That means the liver is working overtime… and that can lead to changes in the liver over time.
“The older you get, the more that the liver is processing, the more likely it is to get fatty changes, which is basically an inflammatory process.,” Dr. Gurevich said.
And that brings us to a really important topic: fatty liver disease.
Fatty Liver Disease Is An Epidemic
Fatty liver disease occurs when fatty deposits form on the liver as a result of inflammation.
It’s associated with alcoholism… but can also occur in non-drinkers and is then called non-alcoholic fatty liver disease (NAFLD).
Current stats suggest 1 in 3 Americans has fatty liver disease! (And many don’t know it.)
It’s also the most common cause of liver disease in the U.S. (aside from alcohol and hepatitis C.)
It’s a precursor to conditions like:
- Heart disease
- Autoimmune disorders
- Sleep problems
- Chronic fatigue
- Underactive thyroid
- Skin issues
Even more importantly for you and I… fatty liver disease is also associated with Small Intestine Bacterial Overgrowth (SIBO)!
The SIBO-Fatty Liver Connection
According to functional gastroenterologist Dr. Steven Sandberg-Lewis, “There’s a study that just talks about the association between gallbladder disease, especially gallstones, SIBO, metabolic syndrome and fatty liver. These are all associated conditions. For a long time now, we’ve known that SIBO is associated with fatty liver.”
Dr. Sandberg-Lewis has multiple theories for what could be causing the association:
“When you get more of the bacteria in the small bowel, they convert the B vitamin choline into a toxic substance called methylamine. It’s toxic to the kidneys. It causes injury to the heart and arteries. It causes injury to the liver. All these things tend to increase inflammation.
Also, with bacterial overgrowth and yeast overgrowth in the small bowel, you get more production of alcohol, endogenous ethanol production, sometimes called Auto Brewery Syndrome. So bacteria and yeast can produce alcohol in the gut. And that’s where you absorb alcohol, in the small intestine. So, when you’re producing even smaller amounts, it can have major effects.”
But he has one other theory, too:
“Also, we know that when you have certain types of bacterial overgrown in SIBO, what are called the gram-negative, they produce a lot of what’s called lipopolysaccharides or LPS which is also toxic to your kidneys, liver, to your cardiovascular system. And it’s a major provocation of inflammation.
In fact, often, when they’re trying to create sepsis or septic shock in mice in a research study, they’ll just give them an injection of lipopolysaccharide, and it’ll put them into septic shock.
Lower amounts I think are really important in many diseases and chronic liver, kidney and heart disease. And it starts in the gut with LPS from bacteria that are overgrown.”
While we don’t know the exact reasons SIBO and fatty liver are related, the association is obviously here… and that means people with SIBO need to be especially aware of liver health.
Learn More About Healing Fatty Liver
Obviously, getting SIBO under control is an important step for liver health long-term – that’s why I’m always available to share as many resources as I can on healing from SIBO!
But there’s also a lot to learn about the liver, and that’s not my area of expertise. Luckily, my friend my friend Jonathan Landsman IS a liver health expert and he wants to share what he knows with all of us!
By attending this 100% free, online event you will:
- Understand the health complications of a fatty liver … that will forever change the way you view your lifestyle
- Get a detailed list of toxins that damage your liver … and trigger a wide variety of health problems
- Learn about the best natural therapies to regenerate your liver … featuring the latest medical breakthroughs
- Discover the link between liver disorders and autoimmune conditions … and how you can fix these problems naturally
- Understand why “the usual” liver enzyme tests are not enough … and, what you need to know BEFORE you experience a health crisis
- Learn why having 2 (or more) kids places an extra burden on the liver … what mothers everywhere need to know
Check out this amazing line-up of speakers and topics >>
This is such an important topic for us SIBO sufferers.. I hope you’ll take the time to watch!
Hope & hugs,
Judging by posts in the SIBO SOS® Facebook Community, many of us who struggle with Small Intestine Bacterial Overgrowth are VERY confused about garlic!
Here are some screenshots of posts we’ve had in the group:
Let me start by saying – I totally understand the confusion! I used to be confused myself.
You may have heard that you shouldn’t eat garlic if you have SIBO… but that garlic is also a popular treatment…. How can that be?
But it’s actually simple once someone explains it to you. I was lucky enough to have Dr. Allison Siebecker explain the difference to me, and today I want to pass that knowledge on to you!
Is Garlic a “Forbidden Food” For SIBO Patients?
This is where all the confusion begins!
Garlic is a high-FODMAP food. FODMAP stands for fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are short chain carbohydrates and for people with issues like SIBO or IBS (irritable bowel syndrome), foods that are high in FODMAPs can increase symptoms like bloating and discomfort.
Many diets for SIBO and IBS recommend limiting high-FODMAP foods and sticking to a low-FODMAP diet.
But defining what foods are “high” and “low” in FODMAPs is a little tricky. There’s no universal standard for high and low, and quantity matters a lot, as well. Even a food that is very high in FODMAPs might be well-tolerated by people with IBS and SIBO in smaller quantities.
To make it even MORE confusing, not all people with SIBO or IBS react to all high-FODMAP foods. Some people might only struggle with oligosaccharides and be fine with polyols, for example. And some people might be able to tolerate one food that is high in monosaccharides but not another.
That means that there is no such thing as forbidden foods for SIBO and IBS. The best diets for SIBO and IBS are “frameworks” for finding the foods that work for you – not black and white guidelines.
The only way to know what foods you can and can’t tolerate it to test them! (To learn more about this, I recommend Dr. Siebecker’s Diet Masterclass).
Garlic is a high-FODMAP food that contains fructo-oligosaccharides that some people with SIBO don’t tolerate – but for others, it is just fine (or maybe only tolerated in small quantities).
What About Garlic Infused Foods?
Some people who develop symptoms after eating whole garlic (like a clove of garlic in tomato sauce) are able to tolerate garlic infused foods (like olive oil).
That’s simply because the short chain carbohydrates that can cause a problem are in the fiber of the garlic.
That being said, some people say that even low-FODMAP garlic infused items cause symptoms for them.
But remember: for all foods, the “dose makes the poison” when it comes to FODMAPs. You might be fine with a hint of garlic but can’t handle a lot. Or perhaps you’re very sensitive to garlic and have to temporarily avoid it altogether.
Or maybe you don’t react to garlic at all… but find you can’t tolerate apples or oatmeal or some other food. We’re all unique and there’s no one-size-fits-all protocol.
But one last thing: just because a food is high-FODMAP or causes symptoms for you doesn’t mean that the food is bad, unhealthy, or has to be avoided for life.
Comparison isn’t helpful in SIBO – just because one person can tolerate garlic and you can’t doesn’t mean you’ll never eat Italian again or are doing something wrong!
Using Garlic To Treat SIBO
Garlic isn’t just a sometimes-problematic food… it’s also one of the most effective natural treatment options for SIBO.
But if many people with SIBO don’t tolerate garlic, how can that be?
According to Dr. Siebecker, garlic is one of the 4 main herbs used to treat SIBO – but it’s not just regular garlic cloves you can buy at the grocery store.
Instead, it’s an extract of garlic called allicin.
“The four main herbs that we use typically to treat SIBO are berberine containing herbs, which are things like goldenseal root, Oregon grape, barberry Coptis. Neem is a traditional ayurvedic and a microbial. We use oregano, like the kitchen herb spice, oregano oil. And then lastly is an extract that comes from garlic called allicin, like my name but it’s spelled different.
And in that one we like to use stabilized allicin extract because garlic is a very fermentable food and triggers a lot of people’s SIBO symptoms. We don’t want to use whole garlic per se like the actual clove taking it down, unless somebody did tolerate that, but it’s pretty common for SIBO people not to. And we don’t want to use like garlic crushed or garlic oil. We prefer the antibacterial extract allicin that’s been extracted out.”
Even if you can’t tolerate garlic whatsoever, you will likely be able to tolerate allicin extract as part of a SIBO treatment because it doesn’t contain the problematic fructo-oligosaccharides.
Why Garlic Is A Key Player In Treating SIBO
There are three main types of SIBO: hydrogen dominant, methane dominant, and hydrogen sulfide.
(Although as research continues to advance, more types and more specifications within each type are likely to be discovered!)
According to Dr. Siebecker, “The special thing about allicin is that this is what treats the methane, methanogenic archaea (which, for ease, we’ll just say bacteria). They are tough to kill. And they need different antimicrobials to kill them. And the extract from garlic does it, allicin. It works against them. We see it clinically. We see it with our before and after breath tests. It’s for real.”
If you have methane, garlic is a must-have for herbal antibiotic treatments.
The Garlic Dr. Siebecker Recommends
If you’re considering taking garlic as part of an herbal protocol for SIBO, here’s what Dr. Siebecker has shared with me in the past:
“Berberine and Allimed is my go-to combination. I think of berberine kind of like Rifaximin, and Allimed like the neomycin or metronidazole, because this is what works on the methane, this is what works on the hydrogen—and you need to do them both.”
Here’s why a two-part treatment is so important:
“The reason you need to do them both is because methane archaea turn hydrogen into methane. So there are already bacteria making hydrogen there, and then there are other bacteria that are turning that hydrogen into methane. You have both there, so you need to address them both.”
And what about choosing the right allicin supplement?
“My go-to is Allimed. And we use the “-med” because it just gives the strongest potency in the least amount of pills. And the dose on this is six a day. And usually, when you’re taking a bunch of pills, we split that into three doses. You can do it as two, three times a day, or you can do it as three, two times a day.”
Help! I’ve Already Tried Allimed (Without Results)
Remember that SIBO is a tricky condition to treat – and typically requires trial and error (if you’re one of the lucky ones who’s very first treatment eradicate SIBO – good for you!).
Dr. Siebecker recommend trying Allimed paired with another herb – if you tried Allimed and berberine, for instance, try Allimed and neem next.
How often can you keep repeating this?
“Keep going until we don’t think it’s working anymore or we see on the test it’s not working anymore,” said Dr. Siebecker.
My Allimed Experience
As a person with methane SIBO, I’ve used Allimed several times.
I have a very fond feeling toward it, as it definitely made a huge improvement in my symptoms!
My pro tip? Keep it in the fridge or freezer. It does have a noticeable “garlic-y” and keeping it frozen helps reduce the odor!
Want to try it yourself?
I know how expensive trying different treatments can be – so I’m excited to be able to share a special discount with you today!
Use code “LOVEMYBODY” for 20% off your order from Allimed!
Have you tried Allimed? Are you going to? Leave a comment and let us know!
At my last webinar with microbiologist and founder of Microbiome Labs, Kiran Krishnan, (if you missed that webinar, catch up here), Kiran graciously offered to share a practitioners-only presentation he recently gave on Small Intestine Bacterial Overgrowth with us!
If you’re like me, you love getting access to the info that’s normally only privy to gut-health experts!
You can watch the entire presentation in the video below. And a special thank you to Kiran for sharing this important talk with us!
And don’t forget – you can also use my “Patient Direct Code” to order supplements directly from Microbiome Labs (which normally requires access to a practitioner!)
Register as a patient with patient direct code “SIBOSOS” HERE: https://sibosos.com/microbiome-labs (this is the first step – you can’t order directly from Microbiome Labs unless you do this).
Then use code “DIGESTIONSOS” for 15% off your entire order! (This coupon is one-time-use only!)
Microbiologist Kiran Krishnan is a SIBO SOS™ fan favorite and the creator of truly gut-changing supplements like Megaspore and Mega IGG.
In this webinar, Kiran walks us through his 3 -step “Total Gut Restoration” process. You’ll learn about the differences between a healthy and unhealthy gut and how his 3-step process helps heal the gut.
P.S. If you want to try Kiran’s 3-step Total Gut Restoration Protocol, he gave us an exclusive 15% off code!
First, register as a patient with patient direct code “SIBOSOS” HERE: https://sibosos.com/microbiome-labs (this is the first step – you can’t order directly from Microbiome labs unless you do this)
Next, add the Total Gut Restoration products you’ll need for the protocol (3 bottles of Megaspore, 2 bottles of Mega Prebiotic, and 1 bottle of Mega Mucosa) to your cart.
Finally, enter code “GUTRESTORE15” at checkout.
Want to try a different product? Register with patient direct code “SIBOSOS” HERE: https://sibosos.com/microbiome-labs, then use code “DIGESTIONSOS” for 15% off your entire order! But this coupon is one-time-use only, so load up your cart!
Q&A With Kiran Krishnan
After the webinar (watch it by clicking on the video above), Kiran was gracious enough to answer questions submitted by viewers when the webinar was live. Here are those questions and answers:
Leigh-Anne C. Is this something we should do during treatment or after?
Kiran Krishnan (KK): This will be a critical part of your treatment, so you would start it during.
Elena V. Thanks for your products!! I have methane sibo and am starting another round of antimicrobials. I started using megaigg, megaspore and restoreflora. My gut likes them. What products should take while taking antimicrobials can I continue use of megaigg, megaspore and restoreflora or should I add something else
KK: Yes, you can continue to use those while on antimicrobials. I would recommend adding in the MegaGuard to address bile flow issues, gastric emptying and HCL production.
Pam M. Does Mega prebiotic have dairy in it? Or Casein?
KK: No, it doesn’t. Although the oligosaccharide is from dairy, there are no dairy proteins or fat in it. The oligosaccharides are purified extracts.
Ingrid W. If we are someone who can not take supplements easily and have to try micro doses. How long can we take micro doses of Mega IGG? Is it something you can stay on long term?
KK: Absolutely, there is no risk, only benefit.
Pam M. Why are immunoglobulins low with leaky gut?
KK: Because of systemic inflammation and compromised immunity.
Laurie B. P. Can SIBO ever truly be cured or is it life management once you’ve been diagnosed?
KK: I absolutely believe it can be cured. There is a mechanism that causes it and its not genetic. If we address that mechanism, it can be reversed. Unfortunately, more often than not, the root causes are not being addressed.
Glaucia S. L. What are the best digestive enzymes and probiotic strains for SIBO? KK: Digest Gold from Enzymedica would be fine and use HU58, RestorFlora and Megasporebiotic for probiotics.
Jeanette F. Jeanette in Stockholm, Sweden here. Is dr Krishnan in touch with any Swedish researchers/MDs?
KK: Hi, not in Sweden.
Mary Kay A. Question: How will MegaPreBiotic affect me, given that oligosaccharides are the fodmaps to which I seem to be particularly sensitive?
KK: These are longer chains and should have less negative impact. However, go slow, use as little as ¼ of a scoop per day to start. But remember to use it after 4 weeks of the probiotic. If you have been on low FODMAP, your large intestinal bacterial are starving for fermentable carbohydrates, which are critical for maintaining gut and immune health.
Marilyn M. Can one take the IgG product continuously with no side effects? Should it be discontinued gradually?
KK: You can absolutely take it continuously. Should you want to stop, you do not have to discontinue gradually.
Glaucia S. L. What test is recommended to found out this problem?
KK: The problem is complex and multifactorial, if you are referring to leaky gut and barrier dysfunction. There isn’t a single test for it. You can rest assured that if you have health issues, there is a high likelihood that the gut lining is compromised.
Robin L. C. I had been taking Megaspore and Megaprebiotic for several months. On a recent GI Map my “Bacillus spp” was flagged high. Do you think that’s a problem? Can you overdo it with the spores?
KK: The GI Map test is archaic, inaccurate and not validated in any study. Their arbitrary flagging of strains as “high” or “low” is nonsensical. Bacillus is normally in the gut at 1X10^6 cfu/g of stool, so their threshold for “high” is way off. These strains are also transient, so they don’t accumulate beyond a certain level.
Marilyn M. I see that there are citrus flavinoids and lemonade flavoring in the Megamucsa. Will this trigger histamine reactions in sensitive people?
KK: We have not seen that at all.
Susan G.I recently started a regime by my nutritionist for healing my gut. Started taking Aloe Vera Gel beginning of September; 2-3 Tbsp a day. I just got back my full Metabolic lab tests today, and my liver tests (AST/ALT) are extremely elevated (I am not at risk for hepatitis, I don’t drink any alcohol, and don’t take Tylenol). I searched online and it says that Aloe Vera Gel can cause adverse liver toxicity?!
KK: That may be true, but I haven’t researched aloe and liver health. Leaky gut is also a big driver of liver toxicity. It is important to use a clinically studied solution for gut healing, you should consider the Total Gut Restoration.
Robin L. C. Do you think that the GI Map is a reliable indicator for Zonulin? My symptoms say my gut is leaky, but zonulin marker is well within range. Also, I was on Megapore and Megaprebiotic for several months. My Akkermansia was still below detectable levels. Shouldn’t it be detectable by now?
KK: The test is virtually useless in detecting strains with any accuracy and zonulin is only partially correlated with leaky gut. Use a more accurate whole-genome sequencing test to more accurately detect to the species level. Tests are not the be all end all in functional medicine, follow your symptoms and how you feel as well.
Marilyn M. Will your protocols help with longstanding autoimmune
KK: Leaky gut is a major driver of autoimmune conditions, the protocol is designed to fix leaky gut, so it should be an important part of supporting your immune system.
May S. F. I am currently taking megaspore and IGG for Sibo. Will I kill my good bacteria by consuming antibacterial foods like onions garlic and coconut oil, even if well tolerated?
KK: Coconut oil will likely kill good bacteria, I would use is sparingly, the rest of the foods are ok.
Glaucia S. L. Having SIBO does it mean there is Leaky Gut?
KK: Almost certainly.
May S. F. And, is it true that sugar substitutes like Splenda can affect gut bacteria adversely, even affecting eyes?
KK: Not sure about eyes, but certainly gut diversity.
Glaucia S. L. Can we measure LPS in a blood test?
KK: In a lab, yes. Not in a doctors office.
Marilyn M. Will the Mega Mycobalance assist in eliminating a systemic fungal infection?
KK: It is designed to do so. We have had success with it in people with localized and systemic issues.
Sonja P. Why does megaspore increase the keystone strains?
KK: Absolutely, then the addition of MegaPreBiotic increases them further.
Ingrid W. If we can’t take Megaspore at a micro dose or Just Thrive – can we try the prebiotic instead to try to work on the gut? Can this be a back door way to recondition and build good bacteria when we have tried over months to get on the probiotics but it was too stimulating.
KK: Sure. There is no issue there.
Karen P. N. I am on a probiotic that was supposedly made for me based on the study of my stool sample. Can I add megasporebiotic and also your additional protocol while also on this custom probiotic? Can you use anything like Biocidin during this time for SIBO or will your protocol alone help SIBO?
KK: You can certainly use the total gut restoration as well, it will only help. Use that first and give it a single round (90 days), if the symptoms of SIBO are still present then, you can look at using biocidin.
Jordan P. what if you have Sibo? can this get rid of id?
KK: SIBO is multifactorial, this targets key underlying causes, there may be a need for other interventions, but try the system first and see how you do.
Katie J-E. Is it ok to start with intestinal mega mucosa when starting spore probiotic or does it hinder your outcome
KK: It is perfectly ok.
Sonja P. Do you distribute your products in Europe too, i.e. Germany? I could only find products in the US.
KK: Yes, either from Romania or the UK. Look at www.microbiomelabs.co.uk
Eliza D.is it ok to just take the megasporebiotic and megaiGG2000 or do i need the rebuild and reinforce too
KK: Ideally you would do all 3 steps, but if you do just the probiotic and MegaIGG, you will see significant benefit as well.
Sonja P. Do the spores settle in the colon or they are just transient – so they get excreted with a bowel movement?
They stay for about 21 days and then leave.
Sonja P. I can barely tolerate any carbs. Do you recommend taking more than two capsules of megaspore in such cases?
KK: Go slow and build up to 2 caps. Once you are there, you can go beyond 2 to 3 or 4 to see if the extra dosing will help.
Michele V. Pimentel said not to take probiotics if we have SIBO, don’t add more bacteria to the situation. Don’t do this if we have SIBO?!
KK: He isn’t referring to spores and he doesn’t study probiotics. Spores can actually bring down the growth of bacteria in the small intestines.
Katie J-E. What do you do if you have low lactobacillus buts have SIBO os ok to just do megaspore and not lactobacillus
KK: Megaspore increases your natural lactobacillus, so it will take care of that issue.
Kristie R. Why are spore based probiotics listed as opportunistic in a GI Map?
KK: Because its an archaic test and is poorly designed. They clearly haven’t read studies on microbiome commensals and composition. Numerous studies clearly define bacillus as a commensal and a keystone genus.
Jeanette F. Chronic constipation? Take full program?
KK: Yup. You should see improvement even in the first month.
Katie J-E. How do you increase lactobacillus bacteria (especially for women) if they are low in lactobacillus but have SIBO and are taking megaspore
KK: Megaspore has been shown in a published study to increase lactobacillus.
Sonja P. Is it possible that the spores could settle in the small intestine – when the conditions are favourable for the spores – like in case of SIBO?
KK: They do function in the small intestine, but once there they modulate the immune response and they bring down the growth of over-grown bacteria.
Glaucia S. L. How to revert it and have a healthy connexion with brain and gut?
KK: You have to fix leaky gut.
Andrea Beth T. can they break through biofilm?
Sonja P. Sometimes the spores can turn pathogenic, what helps the most from your experience to get the situation under control in such a case?
KK: They cannot turn pathogenic; this is a complete misnomer and simply false info that has been perpetuated by competitive probiotic companies. We would never develop and sell and product that could turn pathogenic. They have been completely gene sequenced, tested for virulence factors, etc.
Sonja P. Is restore flora containing sacharomyces also good for constipation??
KK: It can be, yes.
Sonja P. Do megaspore probiotics produce lactic acid?
KK: They produce L+ lactic acid which is then converted to butyrate and other short-chain fatty acids.
Sonja P. Do you have an idea why some people having SIBO can’t tolerate any probiotics and some do? Apart from lactobacillus strains that assists building up secondary bile salts. What are the main reasons?
KK: It likely depends on the nature of their overgrowth, what kinds of microbes are overgrown and how the immune system is responding to the presence of those microbes.
Sonja P. Do you know why Epstein Barr virus causes slowing down of the motor migrating complex and initiating SIBO?
KK: I have not seen good evidence that EPV slows down the MMC.
Over the past few months, I’ve sat down with several digestion experts and asked them questions I had myself and questions submitted by YOU! I’ve rounded them all up here for you to watch.
But that’s not all… I’ve also included all the SIBO SOS™ exclusive discounts we have!
Enjoy the Q&A with each digestion expert!
Want to try products you learned about in this Q&A?
- Microbiome Labs: use patient direct code “sibosos” when you register and code “digestionsos” for 15% off your first purchase
- Bio-Botanical Research: use code “sibosos” for free shipping
- Elemental Heal: use code “sibosos” for 10% off your first order
- ibs-smart: find information on the blood test for IBS (no discount as this is a medical test, but your insurance may cover it!)
Looking for more products I recommend? Head over to the SIBO SOS® Shop!
Kiran Krishnan (Microbiologist and Founder of Microbiome Labs)
Dr. Rachel Fresco (Master Herbalist and Creator of Bio-Botanical Research)
Dr. Michael Ruscio (Creator of Elemental Heal)
Dr. Ilana Gurevich (Discussing Getting The Right Diagnosis)
Dr. Mona Morstein (No-Nonsense, In-Depth Q&A on SIBO and IBS)
Ani Pandit (From ibs-smart Test)
Some links included in this post are affiliate links. When you purchase using an affiliate link, SIBO SOS® earns a small commission (at no additional cost to you). This helps support our work. Thank you!
If you suspect Small Intestine Bacterial Overgrowth (SIBO), the obvious question is: how do I begin SIBO testing?
But – like everything else with SIBO! – the answer isn’t black and white.
There are multiple tests, ways to get tested, and the results aren’t a simple “positive or negative.”
Today, I want to share everything you need to know about accurate and accessible SIBO breath testing so you can feel empowered to move forward with treatment.
Do I Need To Be Tested For SIBO?
If you have symptoms of SIBO like bloating, constipation or diarrhea, and pain, do you really need testing, or is it OK to just move ahead with treatment?
The short answer is YES!
According to Dr. Allison Siebecker, ND, “The symptoms of SIBO are nonspecific. There are maybe 35-40 diseases that could cause the exact same symptoms. Just because you have the symptoms does not mean you have SIBO. And we really need to know because the treatment is going to be different, very different between SIBO to something like lactose intolerance which can cause the exact same symptoms.
The treatment for SIBO is antimicrobials which potentially could disturb a person’s microbiome. We want to be sure that we need to do those treatments if we’re going to do them. The treatment for lactose intolerance is taking lactase enzyme. We don’t need antimicrobials and changing of the diet. It’s very important to know if a person has it. There have been studies actually done on this now on how well can you diagnose SIBO based on symptoms and it was not well at all.”
Dr. Megan Taylor, ND, agrees: “So, often, we get diagnosed with SIBO after a long journey of having IBS symptoms, and we’re like, ‘Yes, that, that’s it. That must be it.’ And oftentimes, it is. But maybe it’s only a part of it. Maybe it’s only 50% of your symptoms, but the rest are due to something else. And that really needs to be addressed. Just this week, I had an example of somebody who thought it was just SIBO all along. It turned out they had Celiac disease.
So, you want to make sure that whatever provider you’re seeing is doing that basic work to screen out some of those big conditions that can mimic SIBO—Celiac disease, inflammatory bowel disease, certain particular food sensitivities or food allergies, those sorts of things.”
Not only is treating SIBO potentially damaging if you DON’T have the condition, but assuming it’s SIBO could mean overlooking the real cause of your symptoms. That’s why accurate testing is so important.
Don’t Rely On These Tests For SIBO | SIBO Testing
Inaccurate testing for SIBO is a huge issue! SIBO can only be accurately diagnosed through a breath test or jejunal aspiration during an upper endoscopy.
According to Drs. Siebecker and Mona Morstein, ND, stool testing cannot diagnose SIBO, but is often ordered anyway.
“There are a lot of docs who think a stool test could diagnose SIBO just because it’s of the intestines. But it can’t. The stool really represents best the very end of the large intestine. It doesn’t show bacterial overgrowth in a separate organ that’s way up above. The stool test can indicate something about the small intestine but they cannot diagnose small intestine bacterial overgrowth. If you see an overgrowth of bacteria in a stool test that diagnosis is large intestine bacterial overgrowth or LIBO,” Dr. Siebecker said.
Dr. Morstein seconded this: “We must stop physicians from doing stool tests and saying this has any indication of what’s going on in the small intestine. [The colon] has 500,000 different bacteria. Say that we do a stool test, [saying] we’re reflecting any microbiome in the small intestine is scientifically completely wrong, completely inaccurate.”
Urine organic acids tests are also sometimes mistakenly used to test for SIBO: “I think [the urine organic acids test] is a really cool test. I love it. It indicates all kinds of things but it can’t technically diagnose SIBO. What it can do is indicate some bacterial metabolites, and if they’re in excess we know that there’s too many bacteria and overgrowth. But what it can’t do is distinguish between the large and the small intestine,” Dr. Siebecker said.
Why Choose Breath Testing For SIBO
For accurate SIBO testing, the most common choice is a glucose or lactulose breath test. Breath tests are non-invasive, and can even be done at home. They’re affordable, even if your insurance won’t cover the test and you’re ordering it yourself.
And most importantly, breath tests correlate with symptoms AND with super-advanced small bowel deep-sequencing being done at research laboratories like Cedars-Sinai, according to Dr. Mark Pimentel, MD.
“There’s been controversy about breath testing.” Dr. Mark Pimentel said, “People say, “Well, it’s not as accurate as culture” or “We don’t know if it means that…” But we [now] show that SIBO can be proven by deep sequencing—greater than 1000 bacteria per milliliter in the gut is SIBO—and that both of those correlate directly with 90-minute breath tests, meaning the breath test is valid. And the most important thing, they all interdigitate with symptoms. We can correlate with diarrhea, urgency and bloating with these markers.
The point is, for the first time, we’ve internally validated the breath test. Breath tests are valid. And they predict response to antibiotics.”
Watch this video from Gary Stapleton, founder of Aerodiagnostics Labs, to learn more about SIBO breath testing:
Now let’s dive into what “breath testing” really is.
Let’s start with a basic explanation of what breath testing is from Dr. Pimentel:
“When you do a breath test, you drink a sugar. And the sugar we prefer to use is lactulose. It’s a non-absorbed sugar. So it stays in the gut and gets all the way to the colon. So you can get a good flavor of what’s going on in the entire gut.
When the sugar sees bacteria, they ferment it. When they ferment it, they produce gases. And we look for the gases that humans don’t produce. And the ones we’ve been looking for are hydrogen and methane. Until recently, just those two.
So, when we see those rise early, meaning within 90 minutes, we know that it’s likely that those gases came from the small intestine.”
Gary Stapleton, founder of Aerodiagnostics Labs, describes it this way: “What are we doing [with a breath test]? We’re collecting breath to determine, for SIBO testing, whether or not we have bacteria in the small intestine. So how would that possibly work?
Well, the body, the human body doesn’t produce hydrogen or methane gas. Hydrogen and/or methane gas is only produced by bacteria fermenting or rotting. So what happens, and why we do a preparation for these tests—and we want to be very specific about that preparation because, if you’re not, you can get variable results that don’t match the clinical impressions.
So, we prep for 24 hours, which is a very specific limited diet; followed by a 12-hour fast, which is typically overnight. It’s convenient for the patient. They wake up. And then, they have a breath collection kit. On a test, they have a collection kit. They’ll collect their breath with a closed capture device.”
Watch this short video (and sneak peek from the upcoming Digestion SOS™ Documentary Series) to see what the collection tubes look like and get tips for accurate testing from QuinTron Instruments (the creators of the equipment used for breath testing).
You can order glucose breath tests directly from Aerodiagnostics. Lactulose test can be ordered by your physician.
Interpreting Breath Tests
To put it simply (as Dr. Morstein did), “There is a great deal of grey interpretational area in SIBO testing. Absolutely not is it always clear yes or clear no.”
Once you’ve successfully completed your SIBO test, you might be discouraged to get back a confusing report that you can’t understand (and maybe your doctor is even mystified by it!).
According to Dr. Taylor, “We have to understand that this is not a perfect tool. Breath testing only gives us possible evidence of bacterial overgrowth. We should make sure that our providers who are interpreting our test have a lot of experience doing it or are at least up to date.
Dr. Rezaie’s team out of Cedars-Sinai published that fantastic breath testing consensus guidelines that came out in 2017. That has been my go-to tool for being able to interpret breath testing in a nuanced way, being able to explain to patients “Gosh! No, your test is definitely positive by all the most conservative reads of the test” or “It’s kind of in that gray area borderline. We should be thinking about what else may be contributing to your symptoms as well.”
If you need help finding an expert who can interpret a breath test, make sure you check out our list of experts, click here.
Hydrogen Sulfide & Flat Line Results
Most breath tests look for three gases: hydrogen, methane, and carbon dioxide (as a control).
Higher levels of hydrogen are correlated with diarrhea, and higher levels of methane are correlated with constipation. But some people also get a “flat line” result – what does that mean?
According to Dr. Pimentel, it may be related to how hydrogen and methane interact in the intestines, and the presence of a third gas: hydrogen sulfide:
“Some people have a machine that only measures hydrogen. Others have hydrogen and methane. And then there are people that don’t even have carbon dioxide. Today, most people have a machine that measures all three. But I’m going to argue that a machine that measures four is even better. And that’s coming in a few more months. Here’s some data on them.
We can distinguish bacteria [overgrowth] from human by using hydrogen, methane and now the new hydrogen sulfide. And it works like this: hydrogen-producing bacteria feed hydrogen to the methane producers, if you happen to have these characters in your gut. As a result, you produce methane.
When methane is there and the methanogens are there, they’re eating a lot of hydrogen to make methane. Sometimes, you get a flat line breath test because they’re eating it all up. They’re just consuming it more than they’re making the methane. But they get energy from this. And this is how the methanogens sustains themselves. They get energy from that.
Now, the sulfate-producing bacteria, the new characters that we’re looking at, 5 hydrogens on the right to make one hydrogen sulfide, using up all the hydrogen. And this, we were always speculating, could be the flat line breath test because the flat line had no methane, no hydrogen at all, patients were having diarrhea and they were sick.
And so we now realize that there’s another gas we haven’t done.”
Hopefully, hydrogen sulfide testing will be available within the next year.
Take a Breath!
Phew, I know this is a confusing and complex topic. I hope this post has been a useful resource for you!
If you’re looking for even more information on accurate testing for SIBO, plus treatments, underlying causes, and more – go browse through the SIBO SOS® library of intensive Masterclasses here.
IBS & SIBO SOS™ Summit Vlog
Today I want to share something I’m really excited about with you: our very first IBS and SIBO SOS® video blog (AKA a vlog!)
This is an excerpt from Dr. Ken Brown, MD’s presentation for the next IBS & SIBO SOS® Summit in 2020! Dr. Brown is the creator of Atrantil, the supplement that has helped so many people deal with constipation and bloating.
Watch the vlog and let us know what you think.
P.S. Please leave a comment and let us know – do you like the vlogs? Do you prefer more written content or more videos?
P.P.S. Don’t forget – the Workshop with Dr. Brown gives YOU the opportunity to ask your specific questions! Add the Masterclass recording which includes the video, audio, and full transcript for your highlighting and note taking to your SIBO SOS® Library, click here.
“When’s the baby due?”
I can’t tell you how many times I’ve been asked this in my life, when the truth is: I’m just bloated!
Yes – bloating and constipation can be minor annoyances for some people – but for others (like me) they can disrupt your entire life and cause serious issues.
That’s why I was so excited when I first discovered Atrantil.
Atrantil is an all-natural herbal supplement that treats the root cause of bloating and constipation and has been life-changing for thousands of people. Learn more here.
Today I want to share excerpts from an interview I conducted with Dr. Ken Brown, MD – the gastroenterologist and researcher who developed Atrantil.
What’s The Difference Between IBS with Diarrhea and Constipation?
“Ten years ago, this is when my journey started. I was actually doing clinical research for big pharmaceutical companies, specifically, we were looking at something you are very familiar with, Xifaxan to treat irritable bowel with diarrhea. It was at that time that it was brought to my attention that we won’t be able to help people that are bloated and constipated because a whole different process is going on.
The underlying cause is bacteria growing where it shouldn’t be. It isn’t that bacteria or good or bad, it’s that they’re just growing where they shouldn’t be. Now we know that if you get labeled as having irritable bowel with constipation, you probably have more methane-producing bacteria. If you get irritable bowel with diarrhea, then the bacteria are probably producing hydrogen. So the underlying cause is bacteria. So when we use the three natural ingredients that are known as polyphenols, which are actually the molecules in the Mediterranean diet, they get rid of the bacteria.”
What Are Archaea?
“A very specific type of bacteria called an archaea bacteria [causes constipation and bloating]. These bacteria live in their own kingdom and they produce methane gas. So as it turns out, methane slows everything down and creates all kinds of different problems and allows more bacteria to grow.
We even know which one it is, it’s Methanobrevibacter smithii. So if we want to get more technical, but let’s just call it a methane producer. It’s easiest.
The methane does several things. We initially thought that it worked as a local paralytic, which in simple terms, it does, it slows everything down. Now I think that there are some animal models that shows that it’s actually discoordinated contraction. So it doesn’t do anything. So essentially it doesn’t move. While it’s there not moving, every little piece of food that you bring into your mouth you’re going to have more time to absorb the calories that are there, once the bacteria are done breaking them down.”
What Causes The Archaea To Overgrow?
“Typically in my practice, I see a lot of second opinions, and it’s classic. Somebody will come in and just be like, “Look, 2016 I was normal and then something happened and I have [constipation and bloating]. This thing has been dominating my life ever since.”
Things that can happen are you can go through a very stressful situation, because that can shock your intestines, changes the motility and allows bacteria to grow. You can get a [food poisoning]infection, postinfectious. So about 20% of all people that’ll actually have a bad bug, they’ll end up having chronic issues with motility leading to bacterial overgrowth.
Typically Salmonella, Campylobacter, Yersinia these bugs that affect the gut. The reason is is because our bodies try to get rid of it and it actually produces antibodies that affect these receptors that affect the motility. So it kind of changes the motility and makes it a chronic situation. Almost an autoimmune situation.
Then the other thing that people forget about all the time is just taking antibiotics can disrupt everything. Then, good old diet, American diet, if you take in lots of processed foods it can be very hard on your gut and they can all affect your gut and it’s a perfect environment for these bacteria to start growing. So it’s the bacteria growing where they shouldn’t be that is the underlying cause.”
How Atrantil Can Help
“So while I’m in my lab I’m looking at this, my research manager came in, I’m from Nebraska, she’s from Iowa, and we got to talking. And she goes, “Holy cow, this is the kind of stuff we were looking at when we were trying to legislation with farmers in the Midwest to add food products to cattle to decrease the methane that they’re belching for the greenhouse effect.”
That was the aha moment. I just went, “Oh my gosh, we have to find all this data.” So we spent the next several years looking at all this data and we realized that if we put three natural ingredients together that had already been put … That we already eat as humans, that already been put as an extract for cattle, we could decrease this archaeabacter, and that’s where the aha moment came.
Now, we’ve recently found out that these indigestible polyphenols like in Atrantil, they go to your colon where you’re own colonic bacteria break them down into beneficial products, which are now called postbiotics. So we’ve heard the term prebiotic, probiotic, now I’m throwing a third term out there, postbiotic.
So Atrantil goes through the lumen, gets rid of the bacteria and then it feeds your bacteria. The more that you feed it what it needs, it’ll populate the healthier bacteria so that you’re not having a methanogen bloom.”
Learn More About Atrantil At A Free Q&A With Dr. Ken Brown, M.D.
On June 20, 2019 at 3:30 Pm Pacific / 6:30 PM Eastern Dr. Brown will be joining me on Facebook Live to do a quick question and answer session about Atrantil, bloating and constipation, and methane-dominant SIBO and IBS.
This Q&A is totally free and open to the public: you just need to join our SIBO SOS™ Community Facebook Group to access it here.
I have the lowest price you will find for Atrantil, up to 38% off, click here.
P.S. If you want to read about community experiences with Atrantil, head over to our Facebook Group and search “Atrantil” to read real member’s thoughts.
Lately, I’ve had candida on my mind.
Not just because I have a Live Workshop coming up with Dr. Ami Kapadia all about fungal overgrowth (aka Candida or Small Intestine Fungal overgrowth (SIFO))…
But also because treating my own fungal overgrowth was a major turning point in my own health.
See, I didn’t realize SIFO could cause the SAME symptoms as SIBO…. I was just looking for the typical candida symptoms (like white tongue and sugar cravings).
But I’m getting ahead of myself now. Let’s go back to the beginning and walk through SIFO one step at a time.
SIFO: Small Intestine Fungal Overgrowth
SIFO stands for Small Intestine Fungal Overgrowth.
Just like with Small Intestine Bacterial Overgrowth (SIBO), SIFO happens when fungal organisms overgrow in the small intestine.
SIFO = Candida
Most SIFO is caused by an overgrowth of the Candida albicans.
It’s 100% normal to have Candida in your body. It should be living in and on your skin and mucous membranes.
But sometimes, the Candida overgrows and gets out of control (we’ll talk about why in just a minute).
SIFO Symptoms Mimic SIBO Symptoms
The most important thing SIBO patients need to know is that they might also have SIFO.
According to Dr. Ami Kapadia, MD, it’s basically impossible to tell the difference between SIBO and SIFO based on symptoms alone.
Bloating, food intolerances, pain – they can all be caused by SIFO and SIBO – alongside symptoms outside the digestive tract (like brain fog).
This can explain why your symptoms stick around even after you’ve successfully treated SIBO – it could be SIFO sneaking up on you.
Risk Factors For SIFO
Here’s what’s even more tricky: SIBO and SIFO also have many of the SAME risk factors.
Here’s what puts you at increased risk of SIFO:
- Motility disorders (gastroparesis, Migrating Motor Complex dysfunction)
- Acid suppressing drugs (like proton pump inhibitors and H2 blockers)
- Pancreatic enzyme deficiency
- Antibiotic use
- Prior GI surgeries (especially colectomy)
- Current use of opioids
What To Do If You Suspect SIFO
If you have SIBO (now or in the past), you should be thinking about SIFO, too.
If you are ready to learn more, I hope you’ll join me for a free Facebook Live Q&A session with Dr. Kapadia on May 22, 2019 at 4 PM Eastern.
Mark your calendars!
P.S. Not a member of our free private Facebook Group? Request to join to access the Q&A with Dr. Kapadia (it’s free) here.
It’s been 4 years since I was diagnosed with Small Intestine Bacterial Overgrowth.
Back then, I was bloated, confused, and overwhelmed.
I felt like SIBO had taken over my life… and I just wanted to get the answers I needed to get better so I could get my life back…
It wasn’t easy, but I sought out all the experts. I examined every angle – and I tried everything (yes, including the elemental diet!)
Today, I want to share 3 things I wish I had known when I was first diagnosed with SIBO.
If I had only known then what I know now…
I can’t, but you can!
#1 SIBO Is Chronic – But It’s OK
When I was first diagnosed, I thought having SIBO was like getting the flu. I thought it was going to suck for a few days, I’d take the right medicine, get some rest, get better, and move on with my life.
Nope… not exactly.
I learned SIBO is actually a chronic condition for most people. Why? Because SIBO is the result of another underlying cause (in that way, it’s more like a symptom of your underlying cause).
Some people have underlying causes for their SIBO that can be treated and resolved. But most of us have underlying causes that will be with us forever:
- Post-infectious IBS (aka autoimmune IBS caused by food poisoning)
- Lyme disease or other underlying infections like Epstein-Barr
- Ehlers-Danlos Syndrome
- MCAS (Mast Cell Activation Syndrome) or other histamine issues
- Structural problems or past abdominal surgeries that have altered the gut (anyone out there missing their ileocecal valve?!?)
- And many more!
When I first learned this, I was devastated. I just wanted to get rid of SIBO and move on with my life.
But after some reflection, it actually brought me a lot of peace and relief.
I learned that every time I had a setback or a day with bad symptoms, it wasn’t a personal failing on my part. It was just part of the condition.
Started to thinking of it the way I’d think about an old foot injury I had. Years later, sometimes that foot pain STILL flares up. I can’t do certain things or it will hurt.
But I also know what to do if my foot DOES start hurting again. I’ve been through it before. Knowing it will get better in a couple of days if I rest it.
When I realized it was the same thing with SIBO… it was like fireworks going off in my brain.
I wish they told EVERYONE this when they got diagnosed. It would have saved me so much frustration and disappointment.
#2 You’re Not Alone – There are MILLIONS Of Us
I used to have a lot of shame and embarrassment around my digestive problems and I didn’t want to talk about them – even with my husband or my closest girlfriends.
I was even embarrassed of the name Small Intestine Bacterial Overgrowth. So not sexy! Bacteria – yuck.
But the deeper I got into researching this condition (and IBS, too) the more I realized – there is nothing to be ashamed about.
Our culture teaches us that:
- Bathroom stuff is private (don’t talk about it!)
- Sickness is something to be ashamed about (so fake that smile!)
Once I got rid of my own shame and was open about my health, I found out pretty much everybody has some sort of digestive issue.
It’s just part of life – and the more open we are about it, the less people have to suffer.
Once I got comfortable with talking about my own problems, walls came down, I connected more deeply with the people around me, and I found an amazing community online of people going through the same thing as me.
(Feeling alone? Come join our SIBO SOS™ Community Facebook Group!)
I think I have been able to get healthier (physically and mentally) because I’ve worked through the shame and embarrassment and found a community of other people in the same situation.
We are all #SIBOSuperheroes!
#3 Nothing Lasts Forever (Including a Negative Breath Test)
I worked really hard to treat SIBO when I was first diagnosed, and I was ecstatic when I re-tested and finally had a negative breath test result!
But – as we know – SIBO has a bad habit of coming back. Because I have post-infectious IBS and adhesions, I’m even more prone to relapses. I was recently treated for a relapse of SIBO.
What causes SIBO to relapse? It really depends on your underlying cause. Because one of my underlying causes is post-infectious IBS, I have to use a prokinetic to prevent relapses. If I loosen up on my prokinetic use, I’ll have a SIBO flare.
But it’s not just that SIBO can come back – what works (and doesn’t work) can also change over time.
For example – lots of people get immediate relief from switching to a low-FODMAP diet. But over time, it usually stops working as well. And (for most people), long-term low-FODMAP diets wind up doing more harm than good.
Your body can develop tolerances to herbs used long-term and prokinetics, too. What worked the first time might not work the 2nd time.
Every time I’ve re-treated my SIBO, it has been a little different than the past times – that’s why continuing education is so important for SIBO patients.
The IBS & SIBO Journey
The day I was diagnosed with SIBO was a happy day. I was so relieved to finally know “what was wrong.”
Days and weeks after, though, were so frustrating. I felt confused, hopeless, and overwhelmed.
I don’t want anyone else to have to feel that way!
- Instead of confused, I understand exactly what’s going on in my body
- Rather than hopeless, I have a plan to treat my SIBO (and prevent relapses)
- Instead of overwhelmed, I feel empowered
Now, I know what to do to get better.
Learn With Me
Newly diagnosed with SIBO or IBS (or even just suspect that’s what you’re dealing with)? I’ve been where you are – and I made it to the other side.
I want to guide you to the other side too – it is my calling in life to help other people with SIBO get relief.
Here’s how I can help you right now: The SIBO SOS® Masterclass Summit.
To be honest – I wish I had named this the “SIBO Solutions Series” – because that’s what the 10 SIBO experts teaching are doing: sharing solutions for relief from SIBO.
There are someone to cover every topic I have found to be vital to healing from SIBO – parasites, hormones, root causes, probiotics, candida, the brain-gut connection, and more. It’s not just “theory” – it’s real information you can put to use right now.
It took me 4+ years to learn all of this – but you’re getting it all in just 10 months. (That’s the benefit of having someone who has been through it all as your guide.)
There Is Hope For IBS & SIBO
I’ve been where you are right now – and I want to help you get the answers you need to get relief, and GET YOUR LIFE BACK FROM SIBO!!
Won’t you join us? This is your chance to join before the next event.
P.S. Sick of SIBO being the focus of your life?? Read this inspiring note we got from Beverly:
“First, thanks for being SIBO rock stars and bringing us this info. I hesitated to sign up because I am so tired of SIBO and other conditions being the focus of my life. But when you came out with the payment plan (and didn’t charge extra for this option –thank you) I really couldn’t resist. Just watched the lecture on parasites, and wow, I made the right choice.” – Sally
Lately, hormones have been on my mind.
I just finished recording a brand new Workshop training with Dr. Steven Sandberg-Lewis, ND about hormones, the gut, SIBO, and how it’s all connected.
Dr. Sandberg-Lewis really explained to me HOW exactly the gut can impact our hormones (and it was information I’d never heard before). If you want to get access to the Workshop, go here.
Hormones are much more than estrogen and testosterone – there are about 50 different hormones in the body, and each has a really important function. They control everything from mood to weight – and they can cause SIBO and other gut issues to get worse (or develop). But having SIBO or other gut issues can also lead to hormone imbalances. It’s a “chicken and the egg” scenario.
Here’s what’s clear: whether you’re a man or a woman, and no matter your age, you NEED to be thinking about your hormone health. And especially if you have SIBO, IBS, or ANY gut issues.
(And especially if you’ve had your gallbladder removed or have had gallbladder issues in the past.)
Ahead of the Workshop with Dr. Sandberg-Lewis, I wanted to share a few interview snippets from past discussions I’ve had with experts about hormones.
My goal is to get you thinking and open your idea to new perspectives about hormones and SIBO.
If you want to go further, please join us for the live Workshop on May 4th.
SIBO & Fertility – Dr. Stefani Hayes, ND
Shivan Sarna: “You do treat a lot of people with SIBO, and also, with fertility issues. Tell us how you have observed a relationship between those two if you would.”
Dr. Stefani Hayes: “I think the relationship came about over several years of practice, especially with a lot of my patients who had unexplained infertility, or fertility struggles from PCOS or endometriosis. A lot of them didn’t have GI issues, but some of them did.
Because a lot of my colleagues are experts in SIBO, we started trying SIBO tests on a lot of my patients, and surprisingly, many of them came up highly positive usually with a methane-type SIBO overgrowth, which was really surprising for us.
And a lot of them didn’t have the constipation pattern that a lot of methane-type SIBO does. But they often had had constipation as young adults or young kids, but had learned over the years how to manage it. And sometimes literally never really struggled with much GI stuff beside some occasional bloating.
But when we addressed the SIBO, it seemed to make a significant effect on pelvic bowl health and their women’s health.
The connection between SIBO & Fertility.
Some got pregnant on their own, naturally, and were able to hold their pregnancies and have sweet, little kiddos.
Others tolerated IVF a lot better, and were able to start ovulating on their own with PCOS, if they hadn’t before, or were able to, with endometriosis, there’s often times—endometriosis is really tricky, and so patients who had had multiple surgeries, and then it re-grew, I definitely saw sometimes after we balanced out the SIBO that the endometriosis would re-grow slower, or not at all.
We would just get a little bit longer window between those surgeries, so that those patients could have more options for trying to get pregnant.”
Shivan Sarna: “Why do you think that is?”
Dr. Stefani Hayes: “Because the small intestine does really overlay, not just the uterus, but over the top of the ovaries, and when I think about methane-type bacteria, it’s a pretty noxious gas.
And if I think about what that might be like, I imagine it would seep into the surrounding region. And for me, I like to have visuals of things that seems to me like a fog or a smog, if you will, that’s in that whole pelvic bowl.
And so again, it’s coming back to that smog—if the neighborhood is not very happy, the some other neighboring structures can really get affected too, in my perspective.”
Cortisol & SIBO – Dr. Mona Morstein, ND
Dr. Mona Morstein: “Cortisol is kind of like Goldie Locks with the bears. Cortisol needs the middle chair and the middle bowl of oatmeal.
If there’s not enough cortisol there is development of gut inflammation. And that’s a problem because from gut inflammation we can lose our protective mucus lining, we can start changing our microbiome, we can start breaking away the IGG immunity there and start reacting to what would necessarily shouldn’t react to and so forth.
But if you have too much cortisol for over time it’s also inflammatory to the lining of the intestine as well.
There are so many ways to work with people along that level of cortisol. Whether it’s getting counseling, addressing their sleep, their stress and relaxation – do they do journaling or gratitude, do they exercise, are they creative? Do they take time, you know to relax, do they get into nature?
Broad-based look at ways that people are feeling bad. We can also of course use homeopathy. I do that quite a lot with people.
Of course supplements such as nutrients that support adrenal hormone functioning, there are botanicals that support and help balance what we call adapter genes. If the cortisol is low it can raise it up, if it’s high it can lower it down.
And of course diet, right? What you eat and drink can be very supportive to adrenal healing or very problematic to adrenal healing.
We can also get into methyltetrahydrofolic law because the adrenal gland needs a lot of mentholated enzyme reactions to have it function well, so it’s a broad-based look at both, since we do know that there is inflammation with SIBO.
Whatever else may be happening in their life, if we’re trying to heal that intestinal lining, heal the lining, heal the leaky gut, heal the nerves having a proinflammatory state is going to work against us in that regard through the cortisol.”
SIBO, Your Hormones, & Weight – Dr. Steven Sandberg-Lewis, ND
Dr. Steven Sandberg-Lewis: “Another really important thing is the “thyro-adrenal,” which is something I made up. Both the thyroid gland and the adrenal glands are so important in normalizing blood sugar, maintaining bone mass, helping with mood and energy and blood sugar, very, very important, and blood pressure as well.
Those glands are so important for the maintenance of normal function. And so often, in standard medicine, the only time you really look at the adrenals is when there’s 90% of their function gone. That’s called Addison’s disease. It’s very rare. It’s an autoimmune disease.
Or when a person has Cushing’s disease, which is when their stress hormone, cortisol levels are so high that everything goes haywire, and we can actually die from it. Very serious condition, which is a little more common than Addison’s.
But in naturopathic medicine and other forms of natural medicine, we like to look at the adrenals before they’re 90% gone because many people have a lot of dysfunction there, and you can’t really—in my book, you can’t really separate thyroid from adrenal. They work so closely together.
So that’s my suggestion is balance your adrenal and thyroid function, so that your blood sugar can normalize, so that you can lose the weight around your waist because that’s one of the better ways that we have of measuring abdominal fat or that apple fat.
The waist circumference for women, over 35-inches is too much. For men, over 40-inches is too much.
And so it’s easy enough to say, “Oh, lose that waist circumference. Bring it down. Just get to it.”
Well, that can be almost impossible. If your insulin levels are very high, and your DHEA levels are very low, and your cortisol is very high, that’s the worst group of hormonal levels that can lead to a waistline that just gets bigger and bigger.
You could lose weight all over your body. Your face might look amazing, but you can’t lose the weight around your waist. And that’s the weight that’s controlling the whole blood sugar issue, which causes GERD and causes SIBO and other digestive problems.
So the thyro-adrenal, if you would, gland is really important there. It’s just my way of letting my student doctors and my patients know that—it’s my way of thinking. It’s a little superficial to be treating somebody’s thyroid and ignoring their adrenal or vice versa. You have to look at both.”
SIBO & Hormone Balance
This blog isn’t meant to be comprehensive – there are plenty more ways SIBO and IBS interact with the hormones that I didn’t get a chance to cover in this post.
If you want to go deeper and really understand how gut health issues like SIBO and IBS can interact with your hormone levels, I hope you’ll attend the Workshop with Dr. Steven Sandberg-Lewis on May 4th.
The Workshop includes a 1-hour class on the link between the gut (and specifically the gallbladder) and your hormones. Then there will be 2 hours of live Q&A with Dr. Steven Sandberg-Lewis. We’re also adding new community discussion before and after the class to help you take your learning even deeper. (You don’t have to attend live, either – we always offer the full recording and transcript. You can even pre-submit your question.)
You can also access this Workshop with the SIBO SOS™ Speaker Series. When you join the Speaker Series, you get access to 10 brand new Workshops and 7 exclusive bonuses for one low price. It’s like buying SIBO knowledge in bulk to save money! You can access the Speaker Series here.
P.S. In the past, we’ve done expert Masterclasses – but starting now, Masterclasses are going to be Workshops. Why workshops? We want to highlight how interactive and action-oriented these events are. It’s not just listening or reading – it’s like being in a classroom with other people! We’ve added some new features to the Workshops, too – learn more here.
P.P.S. Our Workshops are taking what you already love and making them EVEN better, more hands-on, and more useful. I can’t wait. If the Workshop sounds like what you need, please join in here.
SIBO, or Small Intestine Bacterial Overgrowth, is a condition where the good bacteria that grows in other parts of the gut migrate to the small intestine where it’s not supposed to be.
You’ll have symptoms of bloating, stomach pain, cramps, and, of course, gas.
The condition affects close to 60 million people across the United States, and guest, Dr. Mark Pimentel, and I have been chatting over the past year about what causes SIBO and how you can treat it.
About Dr. Mark Pimentel
Dr. Mark Pimentel is the head of the Pimentel Laboratory and the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai Medical Center.
A leading specialist in studying the causes of SIBO, IBS (Irritable Bowel Syndrome), and other microbiome related diseases, Dr. Pimentel has been instrumental in delivering treatments, tests, and classifications of these gut diseases.
Dr. Pimentel believes that a SIBO diagnosis is often overused as it can be a catch-all for many different types of GI disorders and that it’s important to get to the root cause of the issue before starting treatment.
We talk about why your tummy makes noise, even when you’re not hungry and why you should probably be avoiding lactose in your diet. We look at the correlation between SIBO and other gut issues with certain vitamins, minerals, and gasses in the body.
Do you suffer from bloating, especially after a meal? Is there a history of SIBO or other gut-related diseases in your family? Do you supplement with a daily probiotic?
This podcast brought to you by:
In This Episode
- What some of the conditions that cause SIBO are
- Why your tummy makes noise when you’re not hungry and what the migrating motor complex is
- Why people with SIBO should steer clear of dairy products
- What the relationship between SIBO, bacteria, and folate (iron) is
- How methane contributes to weight gain and weight loss prevention
- How you can incorporate probiotics in your diet when you have SIBO
“My job is to prove that you don’t have SIBO first but if you do, then we need to prove why you have SIBO.” (3:24)
“The association between IBS and SIBO is clear. I’d say that probably 70% of IBS is SIBO.” (5:26)
“No human on the planet can drink a gallon of milk without getting bloated, because we only have so much enzyme to break down the lactose.” (9:17)
“You have various layers of protection against the outside world. So your skin on the outside of your body is very non-permeable to ward off infections. However, the gut is very special because you want it to absorb things… but not everything, such as certain toxins or some patients have multiple chemical sensitivities.” (24:05)
Have you ever felt 100% hopeless about your gut health?
Especially when you’ve seen multiple doctors and specialists…
Tried this diet and that…
Tested positive, then negative, then positive again…
I get it! At one point I felt a real sense of hopelessness around my own SIBO and IBS.
First, I took responsibility for my own health. I stopped looking for a doctor to fix me and started trying to figure out how i could heal myself.
Second – I immersed myself in as much information as I could! Everything I learned was like a little nugget of hope. Some things I applied right away (and had BIG results). Other things I filed away for later on.
I don’t feel hopeless anymore – I feel empowered.
I want that for you too. So today, I’m sharing some of my favorite nuggets of hope with you!
I hope these inspire you to keep learning and never, ever give up!
Dr. Mona Morstein, ND: People Get Better
Dr. Mona Morstein: “There’s been a lotta people very poorly treated with SIBO. It’s not necessarily that SIBO is this totally impossible disease to treat. It just means it’s one of, by far, the more complicated ones, which is why, you need to do it in a very step-by-step fashion, addressing all of the components that need to heal in the gut; but when it’s done that way. I know, people get better! For sure! Absolutely! The majority get better.”
Riley Wimminger, MScN: It’s A Marathon
Riley Wimminger: “I think my biggest thing that I always tell people is that it’s a marathon, it’s not a sprint. And to have this concept in your mind that you’re just going to take an antibiotic, and then you’re going to take a prokinetic, and everything is going to be healed, maybe – maybe, you’ll have great results happen. But that’s just not what I’ve seen in most people.
So, don’t feel discouraged when that stuff doesn’t work for you. Just take it at the pace you can and start uncovering what else is going on and be patient with your body. And there will be ups and downs. But ultimately, I really see that, a lot of people, they have this upward trend. It maybe looks like this, but it goes up eventually as long as you stick with it and be patient with yourself.”
Dr. Stefani Hayes, ND: Look At The Bigger Picture
Dr. Stefani Hayes: “We think about SIBO as a chronic illness, like diabetes or something like that, that it has to be managed for potentially a lifetime. There’s every once in a while sometimes the miracle cure, one treatment and they’re better forever. But most individuals, it’s a lifetime’s worth of management, whatever that means, if it’s a modified diet or every few years, getting a re-treatment or just being conscious of the decisions and choices they make, know about some area of weakness for them, and could potentially be an area of weakness for their children.
And so just watching that and working on long-term management, I think, is where we often go.
And I think then it’s a little more empowering rather than disempowering because if the self-expectations and the negative self-talk that can come in when—cheats on the diet, it’s about finding that sweet spot where you live your life, and you enjoy your life, and you don’t struggle with the symptoms whether they be the typical IBS-type symptoms or if they show up differently like my patients have with pelvic pain or menstrual irregularities or fertility struggles.”
Dr. Michael Ruscio, DC: Reframe How You Think About Chronic Conditions
Dr. Michael Ruscio: “And we were talking specifically about how IBS is a chronic condition that has a propensity towards relapse – which is true. But what the public will go to with that understanding is “Oh, my God! This is a chronic condition. I’m never going to be able to get rid of them my entire life.” That’s not really the case.
What more so is the reality is that you can go from having IBS and from having SIBO and feeling awful—being bloated, having constipation or diarrhea and some of these associated symptoms that go along with that like insomnia or fatigue or brain fog – and then you can start feeling way better. You may have occasional times when you flare a little bit. But the example I used with Dr. Siebecker when we were talking on the phone the other day was if you had a bad knee injury in college, every once in a while, your knee may start to ache, you’ve got to do some stretches, you’ve got to do some exercises. It’s not a huge deal.
The same thing with your gut. You may have a flare every once in a while. Not a huge deal! We’re all human. There’s therapies we can use to quell that flare. It doesn’t mean anything is wrong or broken or you’re in a dire situation.”
Trudy Scott, CN: Be An Archaeologist
Trudy Scott: “There’s no magic solution. There’s no “You’ve got SIBO. This is the protocol that you need to do.” You need to try this. And if it works, great. If it doesn’t, you try this. Or you try various different permutations.
I mentioned my diet is not exactly the same as someone else’s diet who has SIBO. You may need to try LDN. It may not work for you. You may try tryptophan, and it may work for you. People will often have this fear of starting something or having to be almost a human guinea pig.
I remember you talking about being like an archaeologist, digging and trying to find solutions.”
Don’t Give Up!
Dr. Allison Siebecker, ND told me that it usually takes about four years for her patients to really figure out how to manage SIBO and IBS, so that they’re not having their lives run by their SIBO.
Learning that was a relief in some ways and a real bummer in other ways. Of course, SIBO and IBS are really obnoxious conditions. We want to get better right away! But once I developed a “long-term” perspective, it gave me peace.
It is so helpful to say, “Yes, this is a chronic condition. This is something that I need to manage.” Once I tried that on as a concept, it made me less anxious because I realized that it was just a new way of being. It wasn’t my preferred way of being, but it was a new way of being that if I at least embraced it, and took the pressure off.
That’s why my company is actually called Chronic Condition Rescue because we are dealing with these chronic conditions (and you really do need to be rescued, or you need to rescue yourself).
The Way Forward For SIBO & IBS
I’ve been where you are right now – and I made it to the other side. Sure – SIBO and IBS are conditions I’ll live with forever, but I’m not hopeless. I’m empowered.
I want to guide you to the other side too – it is my calling in life to help other people with SIBO & IBS get relief.
Here’s how I can help you right now: The 2019 SIBO SOS™ Speaker Series.
To be honest – I wish I had named this the “SIBO Solutions Series” – because that’s what the 10 SIBO experts teaching are doing: sharing solutions for relief from SIBO.
We have someone to cover every topic I have found to be vital to healing from SIBO – parasites, hormones, root causes, probiotics, candida, the brain-gut connection, and more. It’s not just “theory” – it’s real information you can put to use right now.
Every month we have a new expert speaker who teaches the Masterclass and then answers YOUR questions at a live Q&A.
Because SIBO and IBS are chronic conditions, you need continuos information.
It took me 4+ years to learn all of this – but you’re getting it all in just 10 months. (That’s the benefit of having someone who has been through it all as your guide.)
We’ve already had 3 of the speakers present (if you join the series now, you can immediately access those so you can watch whenever you want) and 7 more to come. Not to mention TONS of bonus classes, Q&As and other resources.
(Plus we are adding more bonuses all the time – it’s our way of telling you we appreciate you!)
This is your last chance to join the Speaker Series at this price and with the easy payment plan.
I’ve been where you are right now – and I want to help you get the answers you need to get relief, and GET YOUR LIFE BACK FROM SIBO!!
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In today’s post I’m getting REALLY real (and vulnerable) – talking about a subject that’s hard for many people to broach: depression and anxiety.
Listen – I didn’t want to accept I had Small Intestine Bacterial Overgrowth (so not sexy), or Lyme Disease (from a bug!) so you can imagine my reaction to even considering depression & anxiety as factors in my health.
Didn’t wanna go there…
But that’s why this topic is SO important (and why I’m sharing my own story). Depression, anxiety, and gut health are all linked (in big and little ways).
Today, I’m going to share my OWN story and experiences, and then I’ll share excerpts from discussions I’ve had with various gut health experts about depression and anxiety.
My Story of Depression & Anxiety
First, I should say I never thought I had problems with anxiety or depression. I’m generally a happy and positive person.
But I didn’t realize until I got my neurotransmitters balanced how whack-a-doodle-do they were. They were off!
I had genetic testing that showed I had some imbalances in serotonin and dopamine. My practitioner prescribed low dose naltrexone (LDN) (not an antidepressant – but it can help balance dopamine levels).
It changed my life!
Like I said – I’ve always been a happy person. But my entire life I’ve struggled with a feeling of anxiousness, which I thought was normal. It would come and go. I would walk to that edge. And it was uncomfortable.
But I thought it was normal.
With the right neurotransmitter treatment, my whole entire being has transformed. I don’t feel despair anymore. Of course, if something horrible happened, I would.
But I don’t live on that edge anymore. And I feel like, “Oh, my gosh! Is this how people that don’t have neurotransmitter imbalance live all the time?”
I share this so that you know: it can happen to ANYONE. And the signs aren’t always the ones we think of first (like unable to get out of bed, crying all the time…).
What helped me might not help you – but I hope something in these next excerpts WILL help you.
Dr. Lisa Shaver, ND, MSOM, LAc on Neurotransmitters
Dr. Lisa Shaver: So, absolutely, I would say there could be a link between addictions to anything—addictions to food, addictions to watching TV, addictions to social media, gaming online, to sex, to working out…
Shivan Sarna: Shopping…
Dr. Lisa Shaver: …shopping, absolutely, because of malabsorption of amino acids which feed our neurotransmitters. And neurotransmitters is what we need to feel balanced inside and balanced in the world out there. It helps us interact with us and interact with the outer world.
Shivan Sarna: And who sits around and thinks about “Hey, well, my quadriceps are doing great. My biceps are doing great. How are my neurotransmitters today?” No one talks that way.
Dr. Lisa Shaver: Even the word “neurotransmitter,” people are like, “I think I’ve heard of that before. What does that mean? How do you go about it?”
But I’ve done what I’d call targeted amino acid therapy or neurotransmitter balancing, gosh, for 18 years. And it’s so easy. You just use basically the breakdown of nutrition. You’ll be able to feel whether your balance that day and if you’re taking the right dose that day.
And so every person, again, individualized medicine. You could have a big, burly guy with severe depression and severe anxiety take a very low dose, or you could have a petite person with mild symptoms really need to go high on their dose because it all has to do with the internal biochemistry and our receptor years being able to take that signal and tell the brain and tell the body, “This is what you need.”
So, it’s individualized. You can’t have a standard dose for every person.
Dr. Stefani Hayes, ND, LAc on The SIBO-Depression Link
Shivan Sarna: You were talking about how you help people with SIBO, who have—it manifests also some depression and some anxiety, it’s part of the cascade. What do you think is causing that and what do you do for them? How can we help somebody today who maybe feels anxious or has bouts of depression that could be linked to their SIBO? What’s your take on all of that?
Dr. Stefani Hayes: As a naturopath, we’re trained in understanding the physiology of the body, and thinking about pathology along those lines. And what we know is that a large percentage, over three-quarters of our immune system lives around our gut. And so when there’s some dysfunction with the membrane of our intestine, then some big molecules can come through that can be inflammatory to the immune system, and also across that blood/brain barrier, or irritate the blood/brain barrier in a way that’s maladaptive.
And also, if the body can’t fully break down, let’s say, the amino acids, into the components where they can be turned into neurotransmitters, that can be really hard for depression and anxiety.
For me, it’s about finding that middle ground between helping with the inflammation component, so if it’s a neurotoxic effect, like often times, we talk about gluten for some individuals, and depending on their genetics, gliadin, if it’s not broken down well can be neurotoxic, so then an inflammatory component.
And sometimes just treating the SIBO, tightening up those gap junctions in the small intestine, really decreasing that inflammation in that whole region can help their brain because their body is not under this onslaught of inflammation can help their immune system for autoimmune conditions, where their body is confused.
Again, that smog, a lot goes on when the bulk of your immune system is living in that smog, and then it can mistake, it can attack the small intestine itself because one of the main theories about SIBO is that it’s an autoimmune condition.
It can attack the thyroid, it can attack the joints. And also, thinking about how can we minimize some of these chronic conditions, other chronic conditions, autoimmune conditions, that are really debilitating.
But then the other piece of how do you optimize because the main way to really help people with their products that build amino acids is to hopefully help them break down their foods well for that, or give them supplements, or even if they’re taking pharmaceutical medications, you want to make sure that they’re able to absorb them and assimilate them and get them to the brain in a way that’s efficient. And you can’t do that unless the small intestine is nice and healing.
Trudy Scott, CN on The IBS-SIBO-Anxiety Trio
Shivan Sarna: I know Dr. Siebecker and I have spoken about that, about how people—I mean, it’s pretty well-known if you’ve been studying your SIBO or depending on where you are in it, or IBS, that it is associated with anxiety. And like which came first, the anxiety or the SIBO/IBS, or the IBS/SIBO came first and then the anxiety…?
Trudy Scott: Yes. I’ve got two. And these are quite old ones which is interesting. When I wrote my book in 2011, I didn’t really know much about SIBO. But I did know that it was an issue for me. I didn’t actually have a name for it. I knew it was these digestive issues.
Well, the book came out in 2011. But it had to be delivered in 2009. So this was as of 2009—not ’09, 2010. But I did find two studies then. And these still apply. One was a paper. It was a published in 2008. It’s called State & Trait Anxiety and Depression in Patients Affected by Gastrointestinal Diseases.
And what they found is that “people with digestive complaints such as IBS, food allergies and sensitivities”—and they actually used the term “small intestinal bacterial overgrowth,” but the word SIBO wasn’t really well-known in those days. I didn’t learn about it in school—“the small intestinal bacterial overgrowth and ulcerative colitis frequently suffer from anxiety and depression.
And then, this other one which was published in 2001, Irritable Bowel Syndrome, Anxiety and Depression: What are the Links?
So, this is before there were the studies connecting IBS with SIBO. Now we know that a large proportion of people who have IBS, it is actually SIBO. But what they find in this particular study was that 50% to 90% of people with IBS who visited a doctor, all their digestive issues also had panic disorder, general anxiety disorder, social phobia and even post-traumatic stress disorder, and major depression.
So, there’s the research there. And now, we’ve got newer research that I know you and Dr. Siebecker has talked about. But it’s pretty interesting that this research has been around a long time.
Shivan Sarna: I’m just so glad we have concrete numbers on it to help people who are not believers. It really does help. The rest of us sometimes don’t need the double blind study. We get it. It’s there, it’s there.
Niki Gratrix on ACEs, Trauma, and SIBO
Shivan Sarna: So what if I’m just getting through my life, I’m getting through my day. I’m struggling. I’m hanging in there. I have some joy. I’ve got some days off where I actually relaxed. My gut is not in great shape. I don’t feel traumatized. I mean I’m stressed, but isn’t everybody stressed?
What should we be thinking about in a new way to help ourselves because I think most people are operating like that—actually if they’re lucky. They’re lucky to be operating like that, right? That is a champagne problem right there. How can we dive deeper?
Niki Gratrix: So, “stress” is a widely used word. And we’re going to define more closely what we mean by the word “stress” and dive into that. But what most people don’t realize is, when you’re stressed, most people just think of that as maybe they’re stressed in their mind, and actually you are truly a stressed organism when you have stress. The whole body responds to stress.
And the issue is that most people don’t realize, when you look at the stress literature about adult stress, you use that word, most people kind of think about having too much to do, too many emails, the school runs, that is somewhat stressful. But what people don’t realize is that most of your stress response is actually set up in childhood.
In the stress research, when you have an external stressor, something big like maybe losing a job, or a job stress, the big things that can happen when you’re an adult, it’s not the event itself, it’s the perception and how we respond to it. The problem is that one person actually deals with that fine, and another person, they’ll tell you that “I had this stressful event, and that’s when all my gut problems started” or “That’s when I got this chronic illness. I had this stressful event.”
The point is that you have a bit of stressor at the time. But most likely, it was caused by early life experiences because someone else has had the same stress as you and didn’t catch a physical illness.
And bear in mind that you’re not just stressed in your mind, you are a stressed organism. Your whole body is responding to stress. And we’ll talk about that a little bit more.
If early life stress is what is setting us up for our resilience to stress in adulthood, how sort of prevalent is early life stress?
I’m going to talk about the Adverse Childhood Event Studies which were studies of early life stress in children where they were looking over 17,500 adults. It was done by the CDC and Kaiser Permanente, sort of mainstream researchers. It was a massive study of that many people. And they basically looked at the correlation between the amount of early life stress and the onset of chronic complex illness in adulthood.
The researchers said that, from the time the trauma is happening in the child, they are marinating in inflammatory cytokines from the date the trauma happens.
So, when you get a physical expression of gut dysbiosis, you develop SIBO, you develop whatever digestive issues, it probably started 20 years before. It was cumulative over time. And then, you probably had a trigger event, and then you had a more of a physical manifestation of symptoms.
Dr. Steven Sandberg-Lewis, ND, DHANP Explains Depression & SIBO “Cross Talk”
Shivan Sarna: I know this is a rabbit hole, but I’m okay with this because I really think a lot of people are dealing with this. Are they called SSRI? Is that what they’re called?
Dr. Sandberg-Lewis: That’s the original group, and now, we have the SSNRIs also that affect not just serotonin but norepinephrine as well.
Shivan Sarna: So is the SSNRI, is that Wellbutrin?
Dr. Sandberg-Lewis: I believe so, yes. So those things modulate serotonin receptors as well. At least they affect the reuptake of serotonin from the interneuronic space, and make a stronger serotonin effect.
Shivan Sarna: Could this possibly be one of the connections between the brain and gut? Is this where they’re saying that people—this is such a reach, but people with the altered microbiome could be more prone to depression and mood disorders? Is that the same deal?
Dr. Sandberg-Lewis: It’s a real thing. It is true that even—yes. Digestive problems can definitely cause or add to depression and anxiety through many mechanisms—which I love to get into if you want to, but maybe you don’t want them. There are some mechanisms, but we’ll try to make it more practical.
Shivan Sarna: Would it also be the reverse? So you are depressed, and that leads to more digestive problems. You have digestive problems, that can lead to you to being more depressed. That’s depressing. That whole thing that I just said is depressing.
Dr. Sandberg-Lewis: We call it crosstalk. It goes both directions—from the central nervous system, to the gut, and the enteric nervous system, and the enteric nervous system is interacting very intimately with the microbiota that make up the yeast, the bacteria, the viruses that make up the GI microbiome.
No Shame – Just Information
Since my own journey with these issues, I’ve realized that the stigma around these conditions causes many people to suffer for YEARS in silence.
That’s got to stop. No more shame!
So where do you start if you want to learn more?
First things first – you should always talk to your doctor or practitioner. Every situation is unique and you need someone who can make specialized recommendations for you.
But I also have a quick resource to share: 21st Century Solutions to Depression eBook.
This is a free eBook produced by GreenMedInfo that I found helpful personally. It has lots of new information on depression and anxiety that I hadn’t heard before.
I’d also love to know what our experience with SIBO, gut health, and depression anxiety has been. I think open dialogue on this topic is the MOST important thing we can to get rid of the stigma and get more people the help they deserve. Please leave a comment and share your thoughts!
The first time a practitioner brought up the idea of parasites I immediately thought, “No, nope, no way.”
First of all, the idea of having a parasite or gut infection was so gross to me, I didn’t even want to consider it.
Secondly, I live in Florida, I drink filtered water, I wash all my produce… I just didn’t think it was possible I’d been exposed to a parasite.
But I was 100% wrong. Parasites and gut infections (also called gram-negative bacteria) are actually common – even in the United States, even if you’re very careful and clean (like me!) – and I’ve since learned that there’s nothing shameful about having one.
One of my personal mentors on parasites is Dr. Anne Hill, ND.
Dr. Hill is an expert on pathogenic bacteria and parasites, and she taught me about all the different ways we can be exposed.
Today, I’m going to share 10 ways you can be exposed to parasites and gut infections.
#1 Eating Food Imported From All Over The World
When we were kids, you couldn’t get all kinds of produce all year long. Now you can get asparagus in October and apples in May. How? Produce is imported from all over the world.
Even if you wash your produce like I do, you’re still more likely to be exposed to more parasites and bacteria from all around the world. If you’re eating blueberries grown in Chile, it’s like travelling to Chile as far as the potential for exposure to pathogens.
#2 Drinking Water & Going Swimming
Waterways are only getting MORE contaminated every year. In 2018, outbreaks of cryptosporidium and giardia in the U.S. were linked back to contaminated waterways.
You should definitely filter your drinking water, but you can be exposed to parasitic and pathogenic bacteria by swimming, too. And no – pools aren’t necessarily safer than natural bodies of water. Rivers, ponds, lakes, pools, and the ocean can all be contaminated.
This one is the most well-known risk factor for parasites and gut pathogens. “Montezuma’s Revenge” and “Bali Belly” are two of the ones we hear about a lot.
But it’s not just international travel – even travelling domestically increases your risk of exposure to new pathogens and parasites.
#4 Eating Raw Food
Although many of us with Small Intestine Bacterial Overgrowth don’t eat a lot of raw food, very few of us always eat all food cooked!
When food is cooked, the heat kills bacteria and pathogens. Eating raw or undercooked foods leaves you vulnerable to exposure. If you eat a lot of salad or sushi, you should be aware of this.
#5 Gardening & Exposure To Soil
Do you like to garden or even just occasionally pull weeds in your yard? Exposure to soil increases your risk of pathogen and parasites.
Even if you’re not a gardener, you might be exposed to soil hiking or camping.
#6 Exposure To Insects
Living in a humid environment, I’m no stranger to insects! Spider, mosquitos, ticks, horse flies, and spiders (among other insects) can all spread parasites and pathogenic bacteria through bites.
#7 Contact With Animals & Pets
Our pets carry pathogens and parasites in their body – and we let them lick us and sleep in our house! But even if you don’t have pets at home, any exposure to animals increases your risk.
Hunters are especially at risk because they’re exposed to wild animals.
#8 Having A Family Member in Close Contact
You can control your own risk factors to an extent – like never eating raw food or avoiding swimming – but you can’t control what the people around you do!
If your partner or children have any of these risk factors, you have them too! Close exposure and sharing food, drinks, and other items can all spread parasites and pathogens between people.
#9 Having a Weakened Immune System
If you’re dealing with any kind of chronic disease that weakens your immune system, you’re at a higher risk for parasites and gut infections.This is especially true for people taking immunosuppressant drugs!
But even if your immunity is just taking a hit from a cold or virus, you’re at increased risk.
#10 SIBO Patients
I hate to share this one – but just having SIBO puts you at increased risk of parasites and pathogenic bacteria.
SIBO impacts motility and can impact immunity – both of which make it easier for parasites and pathogens to find a home in you.
Don’t Freak Out!
I didn’t write this list to scare you or make you want to live in a bubble – I wrote it to show that EVERY single one of us is at risk for developing parasites and gut infections… and many of us probably have one right now that is holding us back from optimal health.
The good news: you can be tested and treated – and you can learn the warning signs and preventative measures you can take, too.
I invited Dr. Hill to teach a Masterclass covering all these topics and more.
- What parasites are & where you get them
- What they do to your body (it’s more complex than you might imagine!)
- How to get accurate testing (and not waste time or money)
- How to treat them (specific protocols for EACH common infection!)
Tickets for the Masterclass and Q&A are $59 and include the opportunity to:
- Listen to the questions asked and answered.
- Watch the recording after the event
- Instant access to the recording and professional transcripts
If you’re struggling to get well (and feel like you don’t know what to do next) – this Masterclass and Q&A is a MUST watch.
P.S. How many risk factors do you have? I have 8 out of 10!
I used to think there was NO way I could have a gut parasite. I thought living in the U.S. and drinking filtered water meant I was protected.
Little did I know…
Gut infections and parasites are actually common – even in Western countries. Gardening, eating out at restaurants, swimming, and being in contact with pets or kids all increase your chance of exposure.
And of course, travel exposes you to even more potential issues (I think about my childhood trips to India in a totally new way now).
I also know – thanks to the IBS Smart test – that my IBS was actually triggered by a gut infection: food poisoning.
I don’t want to scare anyone but it is an eye-opening reality check. Parasites and gut infections are a topic ANYONE with the goal of healing SIBO or IBS should be thinking about.
I recently spoke with Dr. Anne Hill, ND about what gut infections and parasites actually do to your body. It was illuminating to say the least – a little disturbing, but very hopeful! I’m sharing some of what she taught me with you today…
#1 Parasites & Gut Infections Cause Nutrient Deficiency
When you have a parasite or infection in your gut, there is a lot of competition for nutrients.
Think about those tapeworm-for-weight-loss horror stories you’ve heard.
But it’s not just worms – all kind of parasites and gut infections can absorb more than their fair share of vitamins and nutrients, ultimately leaving you malnourished.
This can cause crazy cravings, weight loss or weight gain, and nutrient deficiency symptoms (think brittle nails, dry & dull hair, muscle cramps, and more).
#2 Parasites & Gut Infections Degrade Your Gut Lining
Parasites and gut infections degrade the protective lining of the gut called the mucin lining. They do this to break down secretory IGA (which is like the immune system of the gut).
They do this to stay alive: they need to degrade the immune system in the gut to prevent being destroyed.
#3 Parasites & Gut Infections Lead To Food Intolerances
Dr. Hill told me that lots of her patients with parasites and gut infections report that they have LOTS of food intolerances – and that those intolerances are changing all the time.
She explained that this is because gut parasites are able to “switch” the immune system from what she called the innate immune response (the TH1 immune system) to the “food allergy” response (TH2 immune system).
Once the immune system has been switched, patients report new food intolerances every week and can often wind up on a very restricted diet.
#4 Parasites & Gut Infections Release Toxic LPS
According to Dr. Hill, the bacteria that create gut infections have something called a lipopolysaccharide (LPS) layer. Our immune system sees the LPS as a threat and mounts an immune response – leading to more inflammation.
But that’s not all the LPS do – they also decrease the production of butyrate in the gut. Butyrate is a short-chain fatty acid that’s a very important anti-inflammatory. Butyrate keep the gut lining strong and the junctions between the cells that make up the gut wall tight. It prevents “Leaky Gut.”
That means LPS cause harm in 2 ways: inciting an immune response and decreasing butyrate production.
The End Result Is Leaky Gut
When all these factors combine – damaged mucin, decreased butyrate, increased immune response – the strength of the junctions between the cell walls that make up the gut lining decreases.
When you have Leaky Gut, things that should stay in the gut – like food and toxins – are able to flow out into the bloodstream. That can cause systemic inflammation and symptoms like fatigue, brain fog, and may even be a trigger for autoimmunity.
The Leaky Gut – IBS – SIBO Trinity
Over the years, I’ve learned that whenever you discuss IBS and SIBO, you also need to consider Leaky Gut.
They are kind of like a trinity of gut issues:
SIBO can be the root cause of both Leaky Gut and IBS – but it’s not the only cause.
Sometimes Leaky Gut and IBS are caused by other things- but then SIBO can also develop…
It’s a little confusing, but one thing is for certain: if you want to heal IBS and SIBO, you can’t neglect Leaky Gut.
This was something I was guilty of: I got so focused on healing SIBO that I didn’t pay attention to Leaky Gut or other coexisting conditions. I couldn’t get 100% better and I didn’t understand why.
SIBO was a big problem for me – but it wasn’t the ONLY problem! In fact, I’m still working through my coexisting conditions.
(That’s why I’m focusing on SIBO, IBS, AND Leaky Gut in our new docuseries, Digestion SOS™ (look for it in August 2019).
Learn More About Parasites & Gut Infections
Dr. Anne Hill is next up in the 2019 Speaker Series! Last year, Dr. Allison Siebecker told me I HAD to have Dr. Hill as a Masterclass speaker after hearing her speak at a conference. As soon as I met Dr. Hill myself, I agreed. Dr. Hill is incredibly knowledgable but also practical.
Some people are totally open to the idea that they might have a parasite – some people (like myself in the past) are totally repelled by the idea. And that keeps them stuck. If you do have a parasite or a gut infection, it’s not a reflection of your hygiene or anything to be ashamed of. As Dr. Hill taught me: if you eat food, you’re at risk for infection.
Parasites and gut infections can (and do) happen to anyone – especially if you have reduced immune function.
If you want to learn more about gut infections and parasites, her Masterclass and Q&A Session are the perfect next step.
Dr. Hill will be covering these common gut infections – including signs, risk factors, testing and treatment:
- Blastocystis hominus
- Dientaomeba fragilis
- Entaomeba histoytica
- H. Pylori
Plus much more!
Tickets for the Masterclass and Q&A are $59 and include the opportunity to:
- Answers and questions recorded for you to reference.
- Watch Masterclass recording, including the Q&A.
- Instant access to the recording and professional transcripts
If you’re struggling to get well (and feel like you don’t know what to do next) – this Masterclass and Q&A is a MUST watch.
There isn’t a diet left you haven’t tried. You’ve seen doctors, alternative practitioners, MDs, NDs, and everything in between.
You’ve tried herbals, antibiotics, antibiotics & anti-fungals, spent more than you’d like to remember on probiotics, prokinetics, and gut-healing supplements.
The underlying causes has been found and you’ve been tested and retested.
It feels like you’ve tried EVERYTHING to treat your Small Intestine Bacterial Overgrowth.
So why aren’t you completely better yet?
Today, I’m going to explore three alternative therapies for SIBO and Irritable Bowel Syndrome that you may not have tried yet. (This list isn’t comprehensive – it’s just 3 more ideas you might want to go back and look at!)
#1 Take a Hard Look At Your Mindset
If you’re not thinking about your mindset during the SIBO and IBS healing process, you’re doing yourself a huge disservice!
I’ve heard over and over again from hundreds of practitioners that the key to healing SIBO is in the patient’s mindset.
Here’s an excerpt from an interview with SIBO expert Dr. Nirala Jacobi:
“There are studies that I know of that have used gut-centered hypnotherapy for IBS symptoms with over 70% ongoing response rate improvement. So that’s tremendous for me. How do we explain that when we’re saying it’s all due to the bacteria?
I think there’s so much that you have to consider when it comes to SIBO. We need to really start thinking about other things besides always bacteria. I lecture practitioners about this all the time. It’s not about that all the time. I have patients that are in extreme stress. And their symptoms improve when they actually start to really address that.
And I’m not talking about just meditating for 10 minutes – which is wonderful. But it’s fundamentally you taking stock of your life and saying, “How can I change this? How can I change this for the better?”
This is where a lot of people have to go. They have to really dig deep into also their emotional states.”
And when Dr. Jacobi says “deep,” she means dig deeper than you’ve ever dug before.
If you’ve done a lot of work, it’s easy to go, “But I’ve already done that.” Believe me, I’m speaking about myself and to myself when I remind you of this!
I know you always hear “work on your mindset!” but it can be hard to know how to put that into action. Something that has been transformative for me is meditation. A great place to start with meditation is the Headspace App which guides you through short meditations.
#2 Explore Visceral Manipulation
Visceral manipulation is a kind of manual therapy performed by a physical therapist on the fascia, which is the connective tissues between and the skin and the muscles. It’s really strong and stretchy and holds everything in place. It’s part of what holds us all together.
I call my therapist a living CAT scan machine, because I’ll ask her, “What’s that body part?” And she can tell me and she’s like, “Oh, your ileocecal valve is slightly rotated.”
At one appointment, she was palpating around my stomach. It hurt a little bit more. Usually, it doesn’t hurt. None of her work seems to really hurt, which is fantastic.
She described how it felt like my fascia was tight and dry. She said this would explain my left shoulder blade pain and the compressed feeling I felt in my psoas muscle. I had adhesions there from a car accident almost 30 years ago!
Adhesions are like scar tissue inside the body that cause tissues and organs to “stick” together. They can disrupt motility and are a common cause of SIBO. Adhesions are common after surgeries and from trauma like car accidents.
Since we’ve released that, holy smokes, I feel like I can breathe! If you can’t breathe, and it doesn’t feel good, then it is a big deal.
And I just felt shockingly, totally transformed!
But beyond my own personal experience with visceral manipulation, here’s what the incredible Dr. Steven Sandberg Lewis has to say about it:
“Visceral manipulation, in order to help with the mobility of the organs and the abdomen, meaning, their ability to move with respect to each other, move around each other, as well as motility, to move things through the lumen or the inside of the tube [is very important].
Especially bringing the stomach down back into the abdomen and keeping it there, and keeping that lower esophageal sphincter in line with the diaphragm, so they can work together. That’s really important. That’s really effective.
Fascia is a much ignored part of the body that has multiple functions. I’m trained in structural integration, so I’m intimately involved with the fascia. It’s amazing what can change so fast when you relieve an adhesion in the fascia, so that you don’t have a little spot weld anymore, can open up, and things can move and be as long as they’re supposed to be, instead of being all shrunken up like that.
Yes, it’s great. And left shoulder is a common place for stomach, gastric stomach problems to reflux.”
You can learn more and find a visceral manipulation therapist in your area here.
One other thing to consider is Clear Passage – a technique (different from visceral manipulation) that can clear adhesions. More info on that here.
#3 Immunoglobulin Therapy
Immunoglobulin therapy (aka IGG therapy) is something I’ve been hearing about more and more. It pops up as a topic frequently in our Facebook group and other Facebook communities for people with SIBO and IBS.
These treatments work by binding to and deactivating toxins and microbes in the gut. This reduces inflammation and immune response so that the gut lining had a chance to heal. It can even help improve nutrient absorption.
Dr. Michael Ruscio, DC is one of the leaders in the movement toward developing IGG therapies. he explained it to me as not a replacement for other treatments, but an “add-on” that can help tough cases finally turn the corner and start feeling better.
According to Dr. Ruscio:
“I don’t think that there’s one treatment that’s going to be the best at preventing relapse [of SIBO and IBS]. But rather, it’s important to look at this more broadly in terms of figuring out the combination of environmental factors that will allow your gut to remain improved in the longer term.
It’s not just one antimicrobial knock, one elemental knock that’s going to fix everything. But rather, how do we cultivate?
By listening to your gut, the appropriate soil through which you can have health grow, rather than thinking about “this one thing” will be what’s best in the long-term.”
I’m so excited about the possibility with this therapy! And I know you are too – that’s why on Saturday, March 23, 2019 Dr. Ruscio is meeting me over in our Private Facebook Group to give a little more information about the science behind immunoglobulin treatments and answer your questions about them.
P.S. Not a member of our free SIBO SOS® Community Facebook Group?
It starts innocently enough: you decide to try an elimination or other specific diet for Small Intestine Bacterial Overgrowth like:
- SIBO Specific SCD
- GAPS or AIP
At first, taking certain foods out of your diet really helps!
But then there is a fork in the road for almost everyone:
You either get better and are able to reintroduce foods…
Or, your symptoms don’t resolve, and you continue eliminating more and more foods.
It can get to a point where you’re only eating a handful of “safe” foods – and you’re feeling worse and worse every day. You’re scared to eat more foods – but also scared to continue on the path you’re on.
What do you do then?
In this post, I’m talking about the good – and the bad – of using elimination diets for SIBO with Dr. Michael Ruscio, DC.
Dr. Ruscio is often my “voice of reason.” He has a very straightforward, commonsense approach to treating SIBO and IBS – even the very tough cases.
I hope this information is helpful to you!
How Elimination Diets Can Be Useful
Dr. Ruscio uses elimination diets like Low-FODMAP as part of his treatment for patients. He also is an expert of the Elemental Diet, which is probably the most restrictive diet of them all!
Here’s how he describes his treatment approach:
“I start with diet and lifestyle. Step #2 would essentially be things like probiotics and enzymes. They’re inexpensive. They’re generally helpful. You don’t need lab testing to apply those.
And then, Step #3 would be considering some kind of antimicrobial therapy—antifungal, antibacterial, anti-biofilm, antiprotozoal.
And then, one of the final things within the realm of the microbial step, we’ll be potentially considering the Elemental Diet as a different method of antimicrobial. It does more than just antimicrobial, but that’s kind of where I classify it.
And after that, we broaden the diet and try to support the gut with things like fiber and some probiotics—if they’re tolerated.”
The Importance of Reintroduction
Dr. Ruscio views restricted diets as a temporary intervention, not a long-term approach to staying healthy:
“We don’t want to have anyone on a restrictive diet longer than they have to be. This is a general principle. We should be working to use these diets to gain awareness, figure out what foods work, and what foods don’t work, and then, ultimately, be trying to broaden to the widest diet possible. That’s very important.
And for some people, the main thing that’s making them feel sick is the fact that they haven’t tried to push to a broader diet, and they keep going more narrow, more narrow, more narrow. And they haven’t pushed back outwards. Sometimes, that simple change of just trying to loosen up your grip or your rules on the diet can actually be very healing and helpful for people.”
Don’t Let Fear Be Your Motivator
Dr. Ruscio says that those who are MOST successful with elimination or restricted diets are those who approach it with a mindset of curiosity rather than fear.
“We want to motivate patients to buy books or undergo programs or watch documentaries—which is good on the one hand. But we don’t want to “fear factor” them into being compliant or motivated to get them there. I think [fear is] a short-term motivator. I don’t think people are motivated in the long-term.
And that’s why when people say to me, “But we need these labs to motivate patients,” my experience has been if someone is not motivated, and you tell them, “If you eat this food, you’re going to cause all these inflammation for months on end, blah-blah-blah,” they’ll follow that advice for a little while. But very quickly, they’re going to go back to what they feel to be how they want to live their life.
And so, what I would rather do, rather than extrinsically motivating someone with fear, is coach them through, “Okay, let’s tighten up your diet for a little while to see how good you feel. And then, because you’re going to probably want to do this anyway, let’s have you re-introduce… and you’ll probably notice a lot of these foods are okay. Even a lot of these foods the Internet says are bad are okay. But there’s a couple, ‘Ugh, I really didn’t feel well when I eat those.’
And then, they’re going to be intrinsically motivated to avoid those foods. And they’re going to be intrinsically motivated to avoid these foods to the degree to which they have a reaction.”
Remember This If You’re On A Restricted Diet…
When you’re stuck eating a small number of foods, you can feel hopeless – uncertain what to try next or how to progress. Dr. Ruscio has some words of wisdom for you:
“Realize that there is a whole world of therapeutic options. I was just talking with a friend’s girlfriend and she was telling me how she’s had IBS for three years. And she’s tried everything.
“I’ve tried everything!”
I said, “Oh, so the low-FODMAP diet didn’t work?”
Now, you probably have heard of the low-FODMAP. But the point I’m trying to articulate is there’s a lot of options out there for you.
So if you’re feeling defeated, don’t go to despair too quickly because there’s a wide array of therapeutic options available to you. And if you can utilize those in the right way, then there’s a very high probability that you’ll be able to feel a lot better.”
A New Treatment for Tough Cases?
If you’re “stuck” in SIBO limbo and not making any progress toward healing – especially if you’ve tried a LOT of different treatment – I have something to share with you.
It’s a NEW treatment for SIBO developed by Dr. Michael Ruscio: Intestinal Repair Formula.
Intestinal Repair Formula is a blend of immunoglobulins that help restore a healthy immune system. (We get so many questions about immunoglobulin treatments and why I was so excited to learn about this new supplement!)
Here’s a video Dr. Ruscio shared that explains the science behind this therapy.
If you’ve already tried other treatments like changing your diet and probiotics, but you’re not seeing complete resolution of symptoms – watch this video NOW!
Here’s what Dr. Ruscio has to say about Intestinal Repair Formula:
“IRF has been shown to help patients who did not respond to treatments like diet, probiotics, antimicrobials and soothing agents. IRF binds to irritants like bacteria and toxins. IRF allows healing to begin. Due to its healing effect, Intestinal Repair Formula may even improve nutrient absorption.”
I’m so excited about the possibility with this treatment!
(And if you decide to buy, use code SIBO-SOS for $5 off!)
P.S. Do you have any questions about this product or for Dr. Ruscio? Leave them in the comments below!
P.P.S. I want you to know that I take making recommendations very seriously! For this particular product, I was impressed with the amount of time and research that Dr. Ruscio put into to – and with some of the preliminary results. I’ve worked with Dr. Ruscio extensively on past Masterclasses and Summits, and I trust him and find him to be very genuine. While I obviously can’t guarantee that this product will or won’t work for anyone, I can tell you that I think it’s worth considering. My goal is simply to share the information and let you make the decision. And – you should know, I don’t make any profit of the sale of this product.
Is there anything better than a hot cup of coffee in the morning?
I’ve always loved coffee, but I’ve often wondered: is coffee making my Small Intestine Bacterial Overgrowth (SIBO) or Irritable Bowel Syndrome (IBS) symptoms worse?
Because this is one of my #1 questions, I’ve made it a habit to ask as many expert doctors and practitioners as possible what their opinion on coffee is.
Today, I’ve rounded up a bunch of opinions on coffee and I’m sharing them with you.
Dr. Mona Morstein, ND
“On my handout it says “weak coffee is okay,” 1 cup a day. But [do I think it’s good beyond that], no. If people are drinking coffee and they’re getting 10 ounces, 12 ounces, that is gonna work against the gut.
It’s acidic. It’s irritating. And if they have diarrhea SIBO – coffee, caffeine stimulates peristalsis action. It drains the adrenals. It interferes with good sleep. “Oh, but, doc, I just have one cup before 9:00 in the morning!” Yeah, well, there’s no law that says it’s detoxed [before the end of the day].
Coffee tends to wake you up at 3:00 a.m. [That is] the liver clog, the liver time on your Chinese clock. This is the time people wake up because they’re on a drug that their liver has to detox: caffeine. And then you wake up kinda wide awake, right?
If people handle a cup or two of a weak coffee, all right. That’s fine. I don’t think a lot of it is going to be helping them in all of these different wants that we’re trying to get them to be healthier.”
Dr. Ritamarie Loscalzo, DC
“Coffee is stimulating. A lot of people are dealing with adrenal fatigue and they drink coffee to keep them up. Yes, there’s the “Bulletproof” that’s supposed to be fungal free but most coffee that you go and get at Starbucks – there’s a lot of fungus on those beans, those funguses, the aflatoxins and other things. Not good for you. It thins the digestive lining. It actually thins out; the caffeine thins out the digestive lining.
The caffeine will stimulate phase one liver detoxification but won’t do anything for phase two. People start to really like oh, motor up and get phase one stimulated and then phase two just lags behind. And so that’s a problem as well. I’m not a fan of coffee.”
Dr. Gary Weiner, ND
“I don’t like to generalize about that because I think a healthy body can enjoy coffee. I think coffee is a problem for many sick people. Coffee is not a healing agent for sick people.
Why is that? Many reasons. The methylxanthine, the acids in coffee can be very difficult for a bowel. For people with SIBO, coffee is often used almost as a laxative. It stimulates that. Now that could be good to move the bacteria out if it’s constipation predominant or there’s an interruption motility to the point where the bacteria are kind of stuck in the small intestine. The coffee could be good.
But in general, I think if consumed to excess it taxes the adrenal glands because it’s so stimulating and that can be a problem. Very reasonable use of coffee is really a great thing. Now there’s the Bulletproof Coffee, which at some protection as it were and some positive attributes to its negative ones. But I do I think it’s overused.”
Dr. Ilana Gurevich, ND
“Coffee is a tricky one. If you had asked me ten years ago I would have said it was bad, bad, bad, but now they’ve done a lot of studies on coffee. Coffee that’s organic and free trade, in moderate amounts, actually seems to be a good antioxidant and anti-inflammatory.
I am not opposed to coffee in moderate amounts. If you want caffeine, I think you’re going to get more health benefits out of green tea than you are out of coffee, but that’s because the Japanese have been researching green tea longer than the Westerns have been researching coffee. I like green tea more but I’m not opposed to coffee.”
Dr. Megan Taylor, ND
“I think [coffee] is person specific. I think all the research out there is telling us that coffee in moderation, like alcohol, can be healthy. There’s a lot of rich antioxidants in coffee, amongst other things.
For those reasons, I say, if you can tolerate it great. I would say most of my SIBO patients are adrenally fatigued and coffee is that thing that keeps their adrenals boosted. They’re just trying to get through. Our ultimate goal would be to get at what’s underneath that. Help them so that they can get off coffee, because more often than not it’s a false energy and can ultimately burn you out more. Burn those adrenals out more.
Chemicals are used to decaffeinate coffee typically. French water processing helps to remove the caffeine in a healthful way that’s just not adding more chemicals to your cup. If you’re somebody who still wants that cup of coffee but you’re caffeine sensitivity, the decaf version is great.”
Dr. Nirala Jacobi, ND
“Coffee generally is okay. There’s a few caveats to that. And one of them is I would want that person to have organic coffee and there are some issues about mycotoxins. Mycotoxins are toxins that are released by fungi that can remain in certain foods and one of those mycotoxins is an aflatoxin in peanuts and that’s one reason we avoid peanuts besides the fact that it’s a very inflammatory substance.
But with coffee, you know, I’m from Seattle. We tend to line up when we see a green awning, you know. I drink a cup of coffee a day. I don’t think generally there is a problem. The caveats would be the mycotoxin if you’re sensitive to fungi.
The other thing is if you are a very nervous person and some people that have a very poor what’s called caffeine clearance, that’s a measurement of how well your phase one detoxification works and that’s the first part of your detoxification system. If that’s a bit gummed up by all the other things that are happening, then if you’re somebody who drinks a cup of coffee in the morning and you can’t sleep at night that’s not a good thing for you.
Or if you’re somebody who works their jobs and is flogging a tired horse that’s also not such a great thing to do. Will I take it away because people are like take anything away but don’t take my coffee away.
I’m like fine, keep the coffee. But you can’t have your milk in it. You can’t have your soy milk in it. And so yeah, you can have coffee but it’s going to be either black or it’s going to be with very boring almond milk or coconut milk.”
Dr. Tom Messinger, ND
“Coffee is a tough one because people are protective of their coffee. What I have found for a fair amount of my patients is that they’re reacting to coffee as if it were gluten. I’m not talking about the caffeine in the coffee that’s making them ramped up. I’m talking about the proteins in the coffee bean.
A lot of people that are gluten sensitive will react to coffee. It’s what’s known as a gluten cross reactive food. Cyrex Labs has a gluten cross reactive food panel and dairy is almost 100 percent across the board a gluten cross reactive food. The people in their database who they know react to gluten, almost 100 percent react to dairy. Second on the list of gluten cross reactive foods is coffee.”
Experts Don’t Always Agree…
I’ve said it before… even on “simple” things, the experts rarely all agree!
What does that tell us?
Small Intestine Bacterial Overgrowth is super complex – and no two cases are the same. There’s no one protocol that works for everyone: healing SIBO is a different path for each of us.
How do we find the right path?
I believe the answer lies in getting as much information from the experts as we can. Then, we can lean into our own innate wisdom to find what works for us and what doesn’t.
I created the SIBO SOS™ Speaker Series to help bring you ALL the latest information on SIBO – right to your home.
For the rest of 2019, we have 10 expert Speaker Series Masterclass and Q&As scheduled. For a super limited time, you can buy the 2019 Speaker Series and get access to all TEN Masterclasses & Q&As for one very low price. Just $19.80 per Masterclass!
Not interested in all 10? You can always buy each Speaker Series Masterclass and Q&A individually for $59.
P.S. Is coffee a friend or foe to you? I’d love to hear YOUR experience. Please leave us a comment!
P.P.S. Wondering if this applies to coffee enemas too? The short answer is no – coffee enemas are totally different than drinking coffee. I’m working on a new blog post all about coffee enemas, so if that topic interests you, keep an eye out for a new blog post very soon!
Whether you call it methane-dominant Small Intestine Bacterial Overgrowth (SIBO) or a “Methane Bloom” – one thing is for sure:
There, I said it!
And the truth is that methane-dominant SIBO and hydrogen-dominant SIBO are very different – and treating them like the same condition can hold you back in healing… and make you feel like you’re going crazy!
Today I put together 5 facts you might not know about methane – these are compiled from some of my past interview with Dr. Mark Pimentel, M.D.
Dr. Pimentel is one of the leading experts in the world on IBS, SIBO, and methane. He’s the executive Director of MAST, a research program created exclusively to study the causes treatments treatments for SIBO, IBS, and microbiome linked diseases Cedars-Sinai hospital in Los Angeles. If anyone is close to finding a cure for IBS and SIBO, it’s this guy!
I always appreciate the opportunity to learn from him.
So here they are… 5 things you may not know about methane-dominant SIBO:
#1 Methane Causes Constipation
According to Dr. Pimentel, research has consistently shown that people with IBS-C and chronic constipation consistently score higher for methane gas on SIBO breath tests than those with mixed IBS symptoms (constipation and diarrhea) or diarrhea. High levels of methane cause constipation.
#2 Methane Is Associated With Obesity
According to Dr. Pimentel, those who test positive for methane on a breath test have been shown in the data to have higher body mass index numbers (BMI).
Dr. Pimentel explain that there are two reason why methane is associated with obesity:
- Methane slows down gut motility. The longer food stays in your gut, the more nutrients (and therefore, calories) can be extracted from it.
- Methanogens consume hydrogen gas in the gut. Without the presence of hydrogen gas to tell them to “stop!” hydrogen-producing bacteria continue digesting food – leading to more calories being extracted.
#3 Methane SIBO Gets More Common As You Age
According to Dr. Pimentel, the likelihood of all types of SIBO increases with age. But the risk of methane-dominant SIBO especially increases: “In the 90 plus group, that’s the highest methane rates we see in all of our population as a whole.”
#4 Methane Contributes To Brain Fog
Though not formally published, Dr. Pimentel says that in his experience, methane-dominant SIBO patients have more brain fog than do hydrogen-dominant SIBO patients.
#5 Methane SIBO Is Tougher To Treat
“Methane is a tougher beast,” according to Dr. Pimentel.
In his research, methane-dominant SIBO responded to neomycin and Rifaximin treatment. The problem? 4 weeks after the trial, most patients had relapsed.
“Antibiotics don’t seem to have a long-lasting effect on methane as it does for Rifaximin treating the hydrogen,” Dr. Pimentel said.
Have Methane SIBO?
I know firsthand how frustrating it can be!
The good news is that there are experts like Dr. Pimentel who are doing the research we need to find a long-term solution RIGHT now!
We hope to see you there!
P.S. Were any of these facts new to you? Surprising? Leave a comment and let me know!
“Who are you???”
I had just walked into Dr. Mark Pimentel’s office for my first appointment when his nurse looked up and said that.
At first I thought she mistook me for a celebrity (we were in Los Angeles at Cedars-Sinai hospital after all!).
But actually, she was just surprised because Dr. Pimentel hardly ever takes on new patients anymore.
Between researching, teaching, running his own laboratory and directing the Medically Associated Science and Technology (MAST) Program, and treating his existing patients (who have some of the most complex GI conditions in the world) he’s a pretty busy guy.
I was very, very lucky to be able to get an appointment (and to have the resources to fly clear across the country to see him, too!)
That first appointment was life-changing – and every time I’ve encountered Dr. Pimentel since then has equally enlightening.
If you’ve ever heard him speak, you know that Dr. Pimentel has a way of speaking that is direct, concise, and simple to understand – even when he’s talking about crazy-complex concepts.
Today, I’m going to share some of what Dr. Pimentel taught me about fiber, the low-FODMAP diet, and what to eat during Small Intestine Bacterial Overgrowth (SIBO) treatment at one of our last sit-downs.
And if what you learn in this blog post is helpful, make sure you sign up for Dr. Pimentel’s upcoming Masterclass and Q&A part of the 2019 SIBO SOS™ Speaker Series on March 4, 2019.
Fiber and SIBO
Shivan Sarna: People are wondering about SIBO and fiber. How do we get enough?
Dr. Mark Pimentel: The bigger question is, what is enough fiber and do we really need fiber?
The question other than that is, after eating cardboard for 20 years, have we made an impact on colon cancer at all?
A lot of people have been eating fiber because they think it’s healthy and then, now, everybody’s going Paleo and going to even keto diets, and all these diets seem to be even healthier than high-carb diets.
I don’t know that you need a lot of fiber in your diet. I think fiber can be helpful in terms of if you’re a normal person and you want a nice, smooth bowel movement and maybe fiber to help the beneficial bacteria of the colon, have more food.
For SIBO, fiber is no good either.
SS: No bueno.
MP: No bueno. It’s just a lot of fermentation, a lot of gas, and a lot of trouble.
The Low-FODMAP Diet Long Term
SS: Let’s talk about the low FODMAP diet and how we don’t want to allegedly be on it for a really long term because it reduces the variation of the microbiome. Do you agree with that? Should we be thinking about that?
MP: Fiber, yes, leads to more diversity in the colon. But as I’ve said before, if you put fiber in the gastrointestinal tract like beans, it’s going to take a lot longer for cleaning waves to recover. It’s going to take a lot of time for the fiber to evacuate from the small intestine leaving more fermentables there for gas, bloating, and distention.
But, the low-FODMAP diet is not healthy long term, and even those who discover and continue to discuss low-FODMAP diet have suggested that. Bill Chey from Hanover, Michigan presented at the ACG Meeting the first study looking at how bad is it to be on low-FODMAP [long term].
After three months, you start to see micronutrient deficiencies. It is not a long-term solution to IBS, which is what it’s touted for. SIBO was kind of the extension of it.
Now, it can be helpful. So, I kind of tell people, “If you don’t eat any food at all, your SIBO will disappear,” because the bacteria can get no food – but that’s not a solution.
The more you restrict calories, the more better your SIBO will feel. But then you’re going to cause harm to yourself, so you’ve got to find that best practice for you, which is why we sort of developed the low-fermentation diet.
We developed that in 2001 or something, and it’s meant to be 100% recommended daily allowance of all mineral and vitamins, so that you don’t get the deficiencies, and yet calorie-restrictive enough to help SIBO.
What To Eat During SIBO Treatment
SS: When you’re taking Rifaximin or treatment [for SIBO], you say, “Eat whatever you want because we want the bacteria having a party,” so that they’re out and about, so the medicine can do its job of killing it. Is that right?
MP: Yes. [But] I don’t tell people to go and eat like a gallon of Haagen-Dazs ice cream every day to make their SIBO go away!
You want to be a little more open with your diet during SIBO treatment, that’s what I suggest. [But if you go too far] What ends up happening is you’ll feel worse on the treatment thinking that the antibiotic is making it worse, when it’s actually the diet.
I just tell people, just go about your normal business, eat what you normally eat while you’re taking the treatment. You don’t need to hyper activate the bacteria.
SS: Nor would you suggest like really being super strict on a low-fermentation diet?
MP: I would suggest not to be on a low-FODMAP diet while you’re taking the antibiotics because you are restricting calories to a great extent and bacteria will tend to be more resistive to antibiotics in hibernation.
The Complex Becomes Digestible
Anytime I have a conversation with Dr. Pimentel, things that I thought were so complex – like what to eat during treatment – become crystal clear.
He has a true gift for teaching from a patient’s perspective!
That’s why I’m overjoyed to welcome Dr. Pimentel back for another Masterclass and Question and Answer session on March 4, 2019.
If you’d like to participate, we have 2 options available:
- Buy a single ticket for his Masterclass and Question and Answer Session on March 4th, 2019 at 9 AM Pacific | 12 PM Eastern – $59
- Buy the 2019 Speaker Series for access to all 10 Masterclass and Q&As (including Dr. Pimentel’s) PLUS access to an exclusive bonus Q&A Session with Dr. Pimentel on June 7th, 2019 from 12 -1 PM Eastern – $198.
The SIBO SOS™ Mission
My mission at SIBO SOS™ is to connect as many IBS and SIBO patients as possible with the very best doctors in the world.
I have spent more money than I want to think about trying to find out what was “wrong with me.” SIBO is an expensive condition and takes so much time and energy.
Let’s acknowledge that right here and now!
But I also want you to know, I’m in it with you.
So while we can’t all see Dr. Pimentel in person, there is still a way we can all learn from him directly: it’s our Masterclasses!
Myself and the entire team at SIBO SOS™ work diligently to make these programs as accessible and affordable as possible.
Information and Inspiration.. Both are needed to get well.
P.S. Lately I have heard from some people that there is “too much information.” I have felt that way myself at times. My goal is never to overwhelm you, but it is also my calling to share as much as I can! Please, take what you need and leave the rest!
P.P.S. Do you have any suggestions for overcoming the “overwhelm” that comes with a condition like SIBO? Please share with us in the comments.
Depending on who you ask, apple cider vinegar is either a miracle cure-all or just another condiment in the back of the cupboard.
Some people swear by it like it is mother’s milk. And other people are like, “Yeah, you know that apple cider vinegar? It’s not as good as you think it is. Whatever you do, don’t do that.”
If you have Small Intestine Bacterial Overgrowth, you might be even more uncertain what to use apple cider vinegar for, and if it can help SIBO or make your symptoms worse!
Some practitioners advise using apple cider vinegar to boost acidity in the stomach, improve digestion, and treat heartburn symptoms – usually by drinking it diluted in water – but is that a good idea?
I asked 8 SIBO experts, with different backgrounds and training, their opinions – and I know the answers will surprise you.
Dr. Allison Siebecker, ND
“Acid reflux can be from either having too little acid in your stomach, or too much acid in your stomach. You need a test to figure out. The symptom is the exact same for too little or too much acid. It’s so funny because MDs across the board tend to think there’s too much acid and NDs across the board tend to think there’s too little, when in fact it could be either, it doesn’t matter what your degree or training is, it could be either.
The best test you can do for this is the Heidelberg test, with the Heidelberg machine. You need to find an office with a Heidelberg machine and make sure that they do the test in a functional way.
I had a colleague who ran it here in Portland and he had done years, and year, and years of this, seen so many patients. By the time he finally left that practice he said it was about a 60/40, 60% in total of the people that he saw had too little acid, and 40% had too much.
If you can’t get tested you could always do a trial of one of the things that help increase acid and just start slow and increase up, and see how it does for you.
Whether that’s bitters, apple cider vinegar, or hydrochloric acid pills, just start very slow and gently. If you do have too little acid usually you start slow, you increase, and what you find is you can keep increasing up to a set max.
I recommend about 1 tablespoon mixed with a glass of water with meals.”
Kristy Regan, SIBO Nutritionist
“I think apple cider vinegar is great if you have low stomach acid. Basically, if you try apple cider vinegar and it gives you a sour stomach or pain in your stomach, then you know you probably already have enough acid, and you shouldn’t be adding to it. But definitely, for most people, this can be helpful.
So, adding a little bit of bitters in water, drinking that before meal, or one teaspoon of apple cider vinegar in one cup of water before meals.”
Dr. Mona Morstein, ND
“If you have gastroparesis and you’re having food sit in your stomach, and you’re just adding more and more acid (from apple cider vinegar or HCL), you’ve got a real risk of burning out your mucus, and potentially causing not just a stomach ulcer, but also gastroparesis patients do have GERD quite a bit because it’s sitting there too long, and just too much pressure for too long against the lower esophageal sphincter can cause a problem, and there can be some considerable GERD and esophagitis.
So, it’s not necessarily the best thing for a gastroparesis patient overall. Of course, finding the reason why they have gastroparesis might be helpful too.
For apple cider vinegar in particular, considering it’s mixed with oil and a salad dressing with 6- out of 8-billion people a day, I’m not really sure we’re seeing headlines about disease from apple cider vinegar, which is just used all the time, or any vinegar.
I’m not really sure what people are thinking is bad about vinegar. We do know that vinegar may support production of digestive enzymes in the stomach. It also can decrease carbohydrate absorption in people with pre-diabetes and diabetes, so they have less high blood sugar numbers.
If we get a fermented apple cider vinegar from Bragg’s, we get fermented food, which is the best food ever, to put in the gastrointestinal tract, apple cider vinegar breaks down into an alkaline aspect to the body. So it’s anti-acidic to the cells.
Now, I would say there are—when we have patients who have candida, there is the idea that we remove vinegar during the specific treatment of the diet in people with candida, for a month or so while we’re eradicating candida.
But nobody develops candida because they have olive oil and vinegar on their leafy greens at supper. Candida is an antibiotic sugar mix thing. So they can add it back in once the candida is taken care of. But I’m not afraid of vinegar myself.”
Dr. Mark Pimentel, MD
“I don’t have a problem with the concept of supplement hydrochloric acid if you don’t have enough. I don’t think we have enough data to say one way or another that’s a bad thing.
What I can tell you though is, if you’re constipated or you have methane, methane uses hydrogen to produce methane, and that source could be hydrogen gas from the bacteria there, or it can be protons which are acid. So acid, the H+, can be used by methanogens to make methane.
The more you take the hydrochloric acid or the apple cider vinegar if you’re a methane person, you’re going to have more methane.
How do I know that? Because if you looked at a study that we published a number of years ago, people on PPI who had methane, their methane was lower as a result of the PPI—no acid in the stomach, less methane production on the breath test.
Be careful is what I’m saying because you can actually make things worse by taking these if you’re a methane producer.”
Dr. Partha Nandi, MD
“It’s fermented, right, the apple cider vinegar. So you’ve got some people that will actually get benefit from it. If you have damage to your esophagus, I wouldn’t take more acid and acidic stuff. You’re adding more acid where acid is the problem. So if you have esophagitis or damage to the esophagus, then I would not take apple cider vinegar.
And conversely, if you just had heartburn symptoms, and it happens occasionally, or we’ve done an endoscopy—endoscopy is a little scope that’s about half the size of my little finger.
And it goes into your mouth while you’re asleep. It goes into your esophagus and your stomach. And if there’s no damage, then it’s okay to take apple cider vinegar.
It’s not going to help everybody. Like everything else, nothing is going to help everybody. But if it does help you, then go ahead and start taking it.”
Dr. David Jockers, DNM, DC
“Apple cider vinegar is actually really good for vagal nerve activity – bitter herbs in general. We say bitter is good for the liver. Bitters are also good for the migrating motor complex.”
Dr. Melanie Keller, ND
“No. Just no apple cider vinegar with the mother. But I also have family in dentistry and they cringe at the use of apple cider vinegar, especially being in a beverage that people can sip throughout the day.
If you do use it, we’re really specific. It’s best to use a straw. It’s best to rinse with baking soda and water.
And I actually have my patients end brushing their teeth leaving a little bit of baking soda on their toothbrush, not fully spitting everything out and that’s helping balance pH in the mouth because digestion begins in the mouth.”
Dr. Jay Davidson, DC
“There are so many people preaching betaine HCl, apple cider vinegar, all these to increase stomach acid, which I’m fine with that. But ask the next question. What’s the source of that lack of stomach acid? It’s usually from bile not moving right.
And here’s how it all connects.
Your bile is needed to neutralize stomach acid. Your bile is also needed to emulsify fat when you eat food. So let’s just theoretically say your bile is not moving well. It’s clogged. There’s not enough bile to neutralize the stomach acid that the stomach is dumping in the small intestine.
The body’s going to say, “Hey! Wait a minute. Red flag, red flag! Too much stomach acid. Decrease it.” The body decreases stomach acid.
If the bile is not moving right, the body decreases stomach acid. Food is not getting digested properly. And now, all of a sudden, there’s more stress in the digestive tract . You throw that on somebody that’s already got SIBO going on or potentially at risk of developing it, you’re looking at just massive digestive issues.”
Experts Don’t Always Agree…
As you’ve probably realized, experts don’t always agree on even seemingly simple things like apple cider vinegar!
What does that tell us?
Small Intestine Bacterial Overgrowth is super complex – and no two cases are the same. There’s no one protocol that works for everyone: healing SIBO is a different path for each of us.
How do we find the right path?
I believe the answer lies in getting as much information from the experts as we can.
Then, we can lean into our own innate wisdom to find what works for us and what doesn’t. I created the SIBO SOS™ to help bring you ALL the latest information on SIBO – right to your home.
Ready to take the next step on your customized path to healing? Get our free SIBO Recovery Roadmap Guide by clicking here.
The Roadmap was designed by SIBO expert Dr. Allison Siebecker, ND and can help you understand where you are on your SIBO journey and what your next steps might be.
P.S. Do you use apple cider vinegar? I’d love to hear what works for you – please leave us a comment!
To use probiotics… or not to use probiotics – that is the question (when you have Small Intestine Bacterial Overgrowth).
And it’s a BIG question. In fact, it’s one of the most common questions we receive at ALL of our SIBO SOS™ Masterclasses.
While different practitioners have different opinions, I decided it was time for me to ask one of the most experienced researchers in the field of probiotics – Dr. Jason Hawrelak.
Dr. Hawrelak is the mastermind behind Probiotic Advisor and has over 15 years of experience as a researcher, clinician, and teacher.
I sat down with him ahead of our upcoming Masterclass and Q&A on February 10, 2019 to talk probiotics and Small Intestine Bacterial Overgrowth (SIBO). (Watch a preview of the Masterclass in the video below.)
Why Are Probiotics Controversial for SIBO?
The first thing I wanted to know: why does this controversy exist in the first place?
Dr. Hawrelak told me that it all goes back to a big misconception about HOW probiotics actually work.
As we know, SIBO is the result of an overgrowth of bacteria in the small intestine.
Normally, there should be very little bacteria in the small intestine – bacterial growth should occur in the large intestine. But with SIBO, bacteria migrates into the small intestine and starts growing there.
The overgrowth of bacteria is the basis for why some practitioners recommend against probiotics for SIBO.
The thinking is: why would you add MORE bacteria with a probiotic when you already have too much?
At first, that made sense to me – but then Dr. Hawrelak explained that this is based off a big misunderstanding about how probiotics actually work.
How Probiotics REALLY Work
Most people (including many practitioners!) think of probiotics as “colonizers.” That means: you take a probiotic pill, and the new gut bugs take up permanent residence in your gut.
So if you’re low in Bifido strains, you can just take a Bifido supplement and those new Bifido bugs will move in to your gut for good.
But this actually isn’t how it works.
Probiotics aren’t “colonizers” – they’re more like “helpful visitors.”
See, most probiotics do not take up permanent residence in the gut. Instead, they pass through the digestive system.
But they’re not just tourists – while they’re visiting your gut, they can perform many helpful actions.
This means that taking a probiotic supplement doesn’t just add more bacteria to an already-existing overgrowth.
In fact, taking a probiotic can actually help reduce overgrowth (more on that in just a minute).
What Probiotics Can Do
Now we know: probiotics are much more than colonizers. They’re actually more like helpful visitors.
So what do these helpful visitors do while they’re in town?
Research has shown that there are multiple possible mechanism of action by probiotics that can benefit SIBO patients.
Here are some examples:
- Stimulate the Migrating Motor Complex (MMC). The MMC are electrical waves that pass through the body are ultimately responsible for moving food through the digestive system by peristalsis. MMC waves are what causes your stomach to grumble or growl when you’re hungry. In many people with SIBO, decreased motility (aka the MMC not doing its job!) is either an underlying cause or symptom of SIBO.
- Heal leaky gut. Leaky gut (aka increased intestinal permeability) is a coexisting condition of SIBO. It occurs when the tight junctions of the gut become “leaky” and allow undigested proteins into the bloodstream. This results in systemic inflammation that can cause a variety of symptoms.
- Have Selective Antibacterial Properties. This means that some probiotics can specifically kill some bacteria living in the gut. They are like “special forces” seeking out bacteria that shouldn’t be there and killing it. This can help rebalance the gut ecosystem and reduce overgrowths.
- Reduce visceral hypersensitivity. Visceral hypersensitivity is a side effect of SIBO – it’s inflammation in the colon that causes nerves in the gut to be hypersensitive to stimuli. It can cause lasting pain and discomfort – but certain probiotics can reduce it.
- Decrease intestinal inflammation. Inflammation in the intestines is at the root of many SIBO symptoms including pain and food intolerances. Long term, chronic inflammation can have devastating effects. Getting rid of inflammation in the gut is one of the surest ways to feel better.
- Enhance secretory IgA. Secretory IgA is an antibody that is produced in the gut to help keep bacteria populations in check. Some people (either because of a genetic predisposition or a condition like SIBO) don’t make enough secretory IgA to control their gut bacteria populations – which can lead to SIBO (or cause it to be very difficult to resolve). Having more secretory IgA helps rebalance the gut ecosystem.
Probiotics Aren’t Just A Way to Add More Bacteria
As you can see, probiotics aren’t just a tool for adding MORE bacteria – they have the ability to address root causes and symptoms of SIBO.
In a meta-analysis of research on using probiotics in SIBO, probiotics were significantly more effective at getting rid of SIBO than either placebo OR metronidazole (prescription antibiotic).
Probiotics also helped alleviate abdominal pain (one of the symptoms I have struggled with for years!).
How To Make Probiotics Work For You
Probiotics absolutely have the potential to help you treat your SIBO symptoms – and maybe even get rid of it for good!
But not all probiotics work equally well – Dr. Hawrelak says there are some specific strains he doesn’t recommend for people with SIBO.
And other folks have additional sensitivities or conditions that must be considered when picking the right probiotic, too.
I wanted to know exactly how to choose the right probiotic for me, so I invited Dr. Hawrelak to teach a Probiotic Masterclass on February 10, 2019 and do live Q&A!
Here’s what he’s going to cover in-depth at the Masterclass and Q&A:
- The difference between species and strains of probiotics and why it matters
- How probiotics are like dogs (yes, really!)
- Probiotics and IBS – helpful or not?
- How probiotics can stimulate the MMC
- The truth about probiotics and brain fog
- Probiotic myths you probably think are true
- What is the microbiome and why it matters
- What does the microbiome do for us?
- Collateral damage of SIBO treatment
- How SIBO diets can damage the microbiome (and what you can do about it)
How to read probiotic labels
- What probiotic claims really mean
- The importance of strain specificity when choosing a probiotic
- How to dose probiotics properly
- Why formulation doesn’t really matter
- Novel uses for probiotics
- Chance to ask your questions about probiotics
- Not a one-size-fits-all probiotic recommendation
- How to choose your own product based on what you’ve learned
I hope this article cleared up any misconceptions you had about probiotics and SIBO – and that you’ll join us at the Masterclass to learn how to pick the right probiotic for YOU and ask Dr. Hawrelak your questions!
P.S. There’s not one probiotic that works for everyone (Just Thrive is a great fit for me, but it might not be for you!) – that’s why I love this Masterclass – it teaches YOU how to pick the right probiotic for you.
Shivan Sarna interviews SIBO expert, Dr. Norm Robillard
One of the first things I learned about after my Small Intestine Bacterial Overgrowth (SIBO) diagnosis in 2015 was this:
Diet alone is not enough to resolve SIBO.
That’s why many SIBO experts and SIBO doctors recommend using antibiotics like Rifaximin (Xifaxan) or herbals to treat SIBO.
But that doesn’t mean you can ignore diet! (Please don’t ignore it!)
While diet alone can’t cure SIBO, what you do and don’t eat is the probably single most powerful factor in how you will feel day to day. Your diet can make or break your SIBO experience!
One SIBO expert who really gets the importance of diet for SIBO recovery is Dr. Norm Robillard, PhD. He’s a microbiologist, researcher, and former pharmaceutical developer. Norm is also the founder of the Digestive Health Institute and the inventor of the Fast Tract Diet™.
I first connected with Norm during my SIBO summit, and he told me that he recommends people choose “diet over drugs,” when it comes to treating SIBO.
Are you surprised?
My Interview with Dr. Norm Robillard
Shivan Sarna: What approach do you recommend for killing the SIBO overgrowth?
Dr. Norm Robillard: I recommend diet over drugs, including antibiotics, for all but the most serious cases of SIBO. The success rate is high for diets that limit carbs.
Yes, you could come in and you can treat the symptoms with antibiotics. You can kill or inhibit these bacteria—which believe me, my background in microbiology, I spent the first half of my career figuring out how to kill bacteria. That’s what we did. They were the enemy. But we now know, when it comes to gut bacteria, it’s very different. The antibiotics can come in and kill bacteria, producing gas, causing symptoms, but they may also kill or inhibit some of the healthy or protective strains.
If you can go on a diet that accomplishes this—and maybe add some other things, maybe some supplementation, to improve digestion—it seems like a much safer bet than coming in with a powerful antibiotic and maybe doing more damage.
I’d say diet first—unless the case of SIBO is severe and there’s severe weight loss involved, failure to thrive in children. If you had a case of bone fractures where you had severe mineral deficiencies or anemia, maybe in some of those cases.
SS: Right! Put your thinking cap on and make your own decisions with the advice of smart people.
I want to talk about Rifaximin: Rifaximin has been studied to show that it does stay in the small intestine. What are your thoughts on that in terms of wreaking havoc on your whole microbiome, and how you’re saying that it’s probably better to try to do food versus antibiotics. I think, “Yeah, but… and… rifaximin has the ability to stay in the small intestine”?
NR: Yes, it does have the ability to stay in the small intestine and in the large intestine. It stays in the intestines throughout the whole way. That is much better and much safer than an antibiotic that is absorbed systemically, traveling throughout your whole body. Those do carry higher risks. Staying in your intestines is a good thing.
Another thing that’s been explored as a benefit of rifaximin is that, in the small intestine, it seems to be aided by bile salts in terms of its antimicrobial activity.
But, by the way, you can still beat up commensal strains in your small intestine just because there’s not as many bacteria there. There are still some important strains. Again, I’m not throwing my full hat in the ring for antibiotics. There are cases where they are appropriate.
So here, you have Rifaximin staying in the intestine, getting helped by bile acids, helping clear out some of these bacteria. Then it goes into the large intestine, and apparently, because it needs bile for its microbial activity, and 95% or more of bile is reabsorbed in the end of the small intestine, that’s another example of why Rifaximin won’t disturb your large intestinal bacteria. That’s a good thing, but what if we have some SIBO going on there?
It’s also not going to be as effective for treating any kind of excessive fermentation or an overgrowth in the large intestine. You could have somebody who didn’t respond because a lot of the activity of the strains was happening in the large intestine.
SS: How does your approach, your diet over drugs, deal with Small Intestine Bacterial Overgrowth?
NR: Right! Without talking about studies—which I was prepared to do, but it’s a little science-y. But without talking about those studies, I can tell you that whether you did have excess fermentation in the large intestine, as a couple of these studies suggest may be going on, or you have excessive fermentation in the small intestine, any approach that minimizes carbohydrate malabsorption.
You want most of the carbohydrate, if possible, to be digested, fully digested and absorbed into the bloodstream, so they don’t present a big fermentation burden on the intestines. Also, cutting back on some of those fermentable carbs should put these bacteria on a bit of a diet. It should help with bacteria in the small intestine if that’s a problem, or if there’s an issue in the large intestine.
You’d avoid lactose, fructose, resistant starch, fiber, and sugar alcohols. Those are the five types of carbohydrates targeted in the Fast Tract Diet™ approach. Believe me, there is a lot of science wrapped around this.
SS: Obviously. A lot of people experience fantastic results.
NR: I founded the Digestive Health Institute with a simple goal in mind, but it’s a big goal, to help 10 million people transition from drugs and antibiotics to regaining their health with holistic and science-based solutions—such as those that we embraced with the Fast Tract Diet™ principles.
Using The Fast Tract Diet™ For SIBO Recovery
But what’s really amazing about the Fast Tract Diet™ for SIBO is not just that it works to resolve SIBO symptoms (though it does!) – it’s that it’s actually really simple to follow.
Even if you have other dietary restrictions like allergies or being vegetarian (like me!).
It’s a diet you can follow when you’re traveling, when you’re eating with friends and family, and for the rest of your life (if you want or need to).
For people who are wary of using antibiotics for SIBO treatment – or for those of you who have tried every drug treatment out there and are still struggling – the Fast Tract Diet™ is a great alternative.
I am so passionate about the possibility of healing SIBO with the Fast Tract Diet™ that I asked Dr. Robillard if he would take a break from his research to teach my community more about the Fast Tract Diet™ (including how to get started right away!). Ready to learn more?
I’m excited to announce Dr. Norm Robillard’s SIBO SOS™ exclusive Masterclass and Q&A: How The Fast Tract Diet™ Works To Resolve SIBO. You can join the Masterclass by clicking here.
P.S. Have you tried diet as a treatment for SIBO? How did it work for you?
Shivan Sarna interviews SIBO expert, Dr. Ilana Gurevich
Finding relief from your Small Intestine Bacterial Overgrowth (SIBO) symptoms is like putting together the pieces of a puzzle. Each one fits somewhere… the question is what order do you need to fit the pieces together, to come up with a complete picture?
Dr. Ilana Gurevich, a board-certified naturopathic physician and acupuncturist, is an expert in putting the puzzle together for SIBO treatment. Based on her years of experience, she knows what to start with, what to rule out, and what to continue with based on each patient’s individual findings.
Dr. Gurevich has had digestive problems all her life, too. Not only is she incredibly empathetic, but she’s also a very assertive healer. She’s totally no-nonsense, yet warm. Even when I get cynical, she restores my faith in the possibility of getting well. I think she’s an amazing doctor, and I am so glad I am able to introduce you to her.
Phase One: Herbal & Pharmaceutical Antibiotics
Before Dr. Gurevich can start phase one of SIBO treatment, she makes sure a new patient has done a SIBO breath test. This is serious business, and she doesn’t want to guess. This will reveal the extent of both methane levels and hydrogen levels – which is critical information in terms of what to do next from a practitioner’s perspective.
In phase one, Dr. Gurevich will prescribe her patient some kind of antibiotic; either herbal or pharmaceutical. The length of time can be two weeks or a month, depending on the patient and their initial response.
While Dr. Gurevich uses more pharmaceuticals like Rifaximin than herbals, she still relies upon herbals like allicin (which is the antibacterial compound in garlic – in this form it isn’t high FODMAP), Berberine, and Neem for their broad-spectrum applications.
Outside of antibiotics, with methane patients, Dr. Gurevich tends to have good results with a combination of Rifaximin and Neomycin.
Whether a pharmaceutical or herbal medicine, the medication prescribed is based on the individual patient profile.
During phase one, Dr. Gurevich generally refrains from recommending probiotics, which she saves for phases two and three.
Phase Two: SIBO Diet and Motility Aids (Prokinetics)
Phase two begins a new chapter that strictly focuses on diet and helping the motility of the small intestine. If inflammatory bowel disease is a factor, Dr. Gurevich may recommend the Specific Carbohydrate Diet (or SCD for short).
Alternatively, the SIBO Specific Diet or even the Paleo Diet may offer relief from nagging SIBO symptoms. After the issue of trigger foods has been narrowed down, (and they vary from patient to patient) the problem of poor motility can then be addressed.
There is an overwhelming number of choices with motility agents. Some of the more commonly prescribed pharmaceuticals are not available in the United States. FDA approval may be in the works for some of these, but for now that’s just an unverified rumor. One popular motility agent is a medication called Resolor, which is most often used in the half milligram to two milligram dosage.
In the herbal realm, there are many promising options to help with motility. One product trusted by Dr. Gurevich is MotilPro, which is a high dose ginger, 5HTP, and couple of other herbs. According to Dr. Gurevich, MotilPro works wonders, although some people can develop a tolerance to it, so breaks may be needed to keep the medicine’s efficacy.
Breaks are important, because they give your gut a “breather” and can act as a reset button to begin another round of therapy.
As an individual herb, Triphelia can be used, and even bitters, which you can find in your local liquor store.
Who knew that healing doesn’t have to come from just your local pharmacy!
Phase Three: Gastrointestinal Restore – It’s All About the “Silver Lining”
In a perfect world, your gut lining is tight – really tight. Within your GI tract, enterocytes cells (intestinal absorptive cells) get nutrients from two places:
first from the bloodstream, and also from the lumen (the interior of the small intestine).
Food comes down and enterocytes absorb what’s the most beneficial to them – just like internal sponges. It’s when you have intestinal permeability (leaky gut) these tight junctions are porous and inflamed.
To encourage a restored and healthier gut lining, Dr. Gurevich recommends a number of different supplements, including but not limited to:
- Resveratrol (a powerful plant phenol (antioxidant) found in grapes)
- Glutamine (a crucial amino acid)
- Colostrum (first milk from cows that has immune-boosting properties)
- Vitamin A (a cornerstone vitamin with protective functions)
- Zinc Carnosine (a chelate-combo that helps protect a healthy mucous lining)
The goal of Phase Three? That everything you’re now feeding your GI tract is helping to restore it to health and keep it that way.
And something you may not know (and sounds a little freaky, to be honest!):
You regrow a brand new intestine every three months. Most of your stool, believe it or not, is made up of old intestinal cells, not food.
Restoring that Friendly Bacteria: What About Probiotics?
As I mentioned earlier, probiotics are something that Dr. Gurevich recommends for either later Phase Two or Three. And what’s one of the best ways to introduce a probiotic in the healing process?
Make your own yogurt!
Now, homemade yogurt can be coconut or dairy, depending on your individual sensitivities. Homemade yogurt has a much higher probiotic content than commercially available brands you get at the supermarket (even if they say organic). All you need is a yogurt starter, milk of your choice, and a yogurt maker.
A simple recipe for making homemade yogurt?
Take two quarts of half and half (or other milk of your choice) and bring it to a boil. Let the half and half cool to room temperature, and then mix the cooled milk with yogurt starter in your yogurt maker (like Yolife, we have a quick list of products here) for 24 hours. If you can, add fresh fruit or raw honey to make it a really delicious treat.
Don’t Give Up!
Healing from SIBO is possible, but there is a learning curve. Give yourself the gifts of patience and grace, and know that even small progress is still progress.
Do you connect with Dr. Gurevich? She has so much more to teach us. Check out our special event.
Do you make homemade yogurt? What are ways you keep friendly bacteria happy in your gut?