By Dietitian Jill Place AKA The Queen of Leaky Gut
I’m NOT an expert on supplements for SIBO. There are many other websites and doctors, including Dr. Siebecker, SIBO Survivor and SIBO SOS. But I AM an expert about supplements. And I became so quite by accident.
Years ago, when I first became an RD, I was taken to a talk by Jeffrey Bland, one of the godfathers of Functional Medicine, by a chiropractor I was thinking of working with. The chiropractor is long gone … I can’t even remember his name.
But he and I sat in the bar and talked that night after the lecture. At the next table was Jeff … with a friend. His friend left … my friend left, and one of us asked to join the other.
Jeff and I sat in the bar for several hours talking Functional Medicine. I didn’t even know that was its name yet. But I DID know … even instinctively in those days … that what “modern medicine” was doing wasn’t helping some people.
He Inspired Me …
Jeff’s onstage and our bar talk that night inspired me to go in a totally different direction with my budding practice. I was always in the front row at his talks. I became a CCN, a certification in Functional Medicine, helped start the Functional Medicine group of my association, wrote a supplement manual and in certain circles am called “famous”, a “visionary”, and a “trailblazer”.
Jeff and I have run into each other over the years many times. Last time he was receiving an award (he’s received many over the years).
I snuck up behind him and whispered, “Congratulations!”. He turned around and spontaneously hugged me.
I miss those hugs. But I DO understand how busy he is NOW! He once told me that he thought he was a failure. I tried to buoy him up … explained that things take time.
Now he’s a well-sought-after speaker. And Institute of Functional Medicine (IFM) courses now cost $20,000.
Which brings us … quite circuitously … to SIBO … and why it’s so important in not only Jeff’s concept of Functional Medicine. But to me … the QUEEN of Leaky Gut.
What IS SIBO?
SIBO stands for Small Intestinal Bacterial Overgrowth. And, quite simply and obviously, it’s an overgrowth of bacteria within the small intestine.
And why am I so interested in it? Because one study says that 78% of Irritable Bowel Syndrome (IBS) sufferers (AKA Leaky Gut) may also have SIBO.
What causes SIBO? Well … that’s obvious too. Mainly bowel dysfunction (AKA diarrhea and/or constipation) and nutrient malabsorption (AKA Leaky Gut … if you want to know what causes THAT, read my article, What IS Leaky Gut?).
I was also shocked to know … from my research … that 10% of people who have severe food poisoning will develop post-infectious IBS(PI-IBS) AKA SIBO. A little over a year ago, I had just that. It put me in the hospital. And my symptoms have gotten worse and worse ever since. Lately, I even have the brain fog that’s one of the main symptoms of SIBO.
Other symptoms include:
- abdominal cramping
- diarrhea and/or constipation,
- poor nutrient absorption
- weight loss or gain … and many more
Two Types of SIBO
There are two major types … hydrogen- and methane-dominant … gases that occur as a result of bacterial fermentation of food in the small intestine. Methane-dominant most often needs to be treated first with pharmaceutical antibiotics.
Commonly prescribed for SIBO are Neomycin, Metronidazole, and Rifaximin. A normal course is two weeks. So, obviously, you need to work with an open-minded doctor who’s willing to not only accept the SIBO diagnosis but treat it accordingly.
If you want to find out which type you have, Aerodiagnostics is my favorite test for that. The customer service is A-one, you can order it yourself (or have me expedite it for you) and the test is covered partially by some insurances.
Even if you have Methane-dominant SIBO, the following treatment is suggested after medication. For the Hydrogen-dominant type, treatment can be solely:
- Diet and Lifestyle
- Natural anti-microbials
- Adrenal support
- Digestive enzymes
- Prokinetics (Motility Support)
- Binders and Biofilm Busters
As a matter of fact, I’d suggest you start the diet right away … here are some guidelines …
Diet and Lifestyle
Many people use a low-FODMAP diet (there are many versions … here’s one … and an even simpler one) for SIBO. FODMAP is an acronym for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. And the theory is … the less fermented or potentially fermentable foods you eat … the more you’ll starve out what I call “The Bad Gut Guys”.
But I prefer my Heal Your Gut Diet. As it’s much simpler. And you can even go as slow as you want with my FOUR-STEP PLAN. But I’d suggest, if you want this GONE, that you dive right in with a strict program … and see how you feel in two weeks … a short time for perhaps big wins …
The Heal Your Gut Diet will be available next week, so check back then. Meanwhile, let’s talk lifestyle. A lot of my treatment in the past few years when I’m working with clients has been about stress management.
Because, if you read my article, 4 Ways Stress Causes Leaky Gut, you’ll see that stress is just as lethal for leaky gut (and SIBO) as bad diet and other poor lifestyle choices. And one way that you can cope with stress is my Micro-Mindfuls … snippets of sequential mindfulness.
I made these so you could chill out a few minutes every day (or string a bunch of them together for a longer practice) just by turning on a video and listening to my voice. You can access them all by CLICKING HERE.
Other lifestyle changes include daily exercise (mix up breathing-and-flexibility things like yoga and Qigong (Tai Chi) with aerobic-and-muscle training like hiking, running, and weights) and daily socialization. I live alone, but I make sure I have meaningful connections with friends and family often.
So … YOUR DIET AND LIFESTYLE ACTION PLAN STARTS WITH …
- Low FODMAP diet for two weeks (or follow the instructions for the first two weeks in the Heal Your Gut Diet) and continue the Heal Your Gut Diet for at least 1-2 months before moving to the next phase in the KICKSTART YOUR HEALTH DIET (also coming soon).
- Some sort of stress management, daily exercise, and/or socialization.
It would be great if you could balance you gut with just diet. But many can’t get rid of SIBO without some healing supplements.
Here are my choices. These recommendations will all be available as a “Supplements for SIBO” template on my Fullscript Supplement Dispensary. I’ll be giving you directions about that in the near future too.
I would recommend, however, that you consult with an expert like me before beginning any supplement program. Because,one of the aspects of Functional Medicine (I’ve been an advocate and practitioner since I met Jeff) is that everyone is individual. And needs to be treated individually.
Meanwhile, here are my supplement picks broken down by type. Soon … when you check out Fullscript (join my list for these by signing up for any of my freebies … 3 Powerful Secrets to Lasting Weight Loss, the Low Salicylate Diet, or the Pegan Diet) SPECIFIC recommendations for brands …
Many, many research studies have confirmed probiotics … different strains of “Good Gut Guys” … friendly bacteria to repopulate the gut … as a crucial cornerstone of treatment for IBS and SIBO. That’s probably why you hear about them everywhere!
Many probiotics sold today are general strain combinations that supposedly help with gut health. But there are specific strains (there are hundreds … and many haven’t even been discovered yet) that help with IBS and SIBO. They are, according to sibosurvivor,com:
- Saccharomyces Cerevisiae Boulardii (mostly helps with diarrhea)- studied in SIBO and SBS
- Bifidobacterium lactis HN019- studied to help slow transit time
- Lactobacillus reuteri (DSM 17938)- studied to help methane and constipation
- Lactobacillus plantarum 299v- studied to help IBS
I also like soil-based probiotics, and often recommend a rotation of the above with blends of them.
Digestive enzymes help break down foods quickly so that less fermentation and, therefore, less gas and overgrowth can occur. A broad-spectrum enzyme (and sometimes a stronger pancreatic enzyme) is best. Take with meals to assure good digestion.
Any supplement program should begin with adrenal support. Because people with SIBO and IBS often feel tired, stressed, and depressed. And changing things in your body can cause even more stress and exhaustion.
To help these symptoms, herbs for the adrenals, glands that are located atop your kidneys, can go a long way to stimulate better mood, vitality, and digestion.
YOUR SUPPLEMENT ACTION PLAN STARTS WITH …
- Start one strain-specific probiotic slowly (it’s better to begin with one strain than a blend) for at least 1-2 weeks. If you feel worse, try another. This whole treatment is about patience, individuality, and trial-and-error.
- Also begin digestive enzymes at each meal.
- Add adrenal support herbals.
- In other words, you’re doing a health self-experiment to see if diet, lifestyle, and supplement changes can improve your symptoms. If not, it may be a good thing to schedule a ONE + ONE package (an in-depth initial and one follow-up virtually) with me to see what’s not working.
- Whether you see me or continue treatment with the following supplements, keep going with the diet by all means. Some people take more time to improve than others.
Herbal antibiotics may be as effective and pharmaceuticals for SIBO WITHOUT the bad side effects. And many don’t do away with “The Good Gut Guys” like medicinals, which will kill most of the bacteria … good AND bad … in your gut.
Also, constant use of antibiotics in meats has made us antibiotic-resistant. So many types may not even be effective.
I’m not a huge fan of antimicrobial herbal blends as they may overwhelm a weakened digestive system. Therefore, it’s best to rotate two or three of these (take one one day, another the next, and so forth):
- Caprylic acid
- Oregano oil
- Olive leaf extract
- Allicin (garlic) … and others …
Lack of motility (delay of passage of waste through the gut AKA constipation) is one of the causes of SIBO. And one of its more painful, upsetting symptoms.
Therefore, it’s important to include a “motility activator” (an actual supplement) in your supplement regime. You can do this after or with antimicrobials depending upon how severe your lack of motility is.
Binders and Biofilm Busters
I can’t find these type of supplements in ANY treatment protocol for SIBO. But I always include them because they’re vital in making sure you kill offending bacteria. And bind them so that they can be removed safely from the body without bad side affects.
Binders, like activated charcoal, fulvic acid, and humic acid, trap dead bacteria, parasites, and other toxins and remove them from the body. They are vital in treatment as what is known as “die-off” can make you even sicker. Then you won’t know if what’s you’re doing is effective or not.
Also, I only recommend that you take these AWAY from food and other supplements as binders, especially activated charcoal, bind EVERTHING. And take only for a short period of time … with the antimicrobials.
Biofilm busters are also important at that time. Because bacteria build what can only be described as “angry birds structures” (“Angry Birds” is an online game where you use some “birds” to destroy structures in which other “birds” are hiding). In other words, they construct scaffolds to keep them safe from the onslaught of antibiotics and herbals.
So … in order to get to the bacteria in the first place … you need to take a complex mixture of enzymes, peptidases (protein-specific enzymes) and EDTA. There are … at this writing (fortunately) … no pharmaceutical drugs for biofilms. And the supplements can be very strong for some. But … like everything else in this protocol … you can start slow and build up to a normal dose … even just taking part of the capsule if necessary.
FINAL SUPPLEMENT ACTION STEPS INCLUDE:
- Begin antimicrobials, binders, and biofilm busters and continue for 1 to 2 months
- Afterwards (or during depending upon the severity of your constipation), begin the prokinetics and continue with the basic plan, including the KICKSTART YOUR HEALTH DIET and supplements suggested in your initial supplement action plan.
- If none of this works or you still don’t feel 100% (or even before to figure this all out) book a “Prescription Solution” session with me by CLICKING THE BUTTON BELOW.