Third SIBO Treatment Complete

Last week I finished the second month of my SIBO protocol from Dr. Ruscio. You can read about what the exact protocol was here.

To sum it up, I’d say my gut symptoms are about 80% better compared to before I started the protocol. I have had some other effects, which I’ll tell you about in a minute.

But first, I wanted to share how I did with the protocol and the tweaks I made.

In this post I wrote about how I started feeling a lot worse after adding in the saccharomyces. Well, I debated between trying to stick it out and follow the protocol to a T, or really listen to my body and understand it was telling me something. (When your body isn’t functioning correctly, it can sometimes be deceiving to listen to every sign and symptom and wonder if it means something important.) In this case, I determined the saccharomyces just wasn’t working for me. After cutting it out of the protocol, I did notice an improvement in my symptoms.

Otherwise, I followed the treatment pretty closely. I took the antimicrobials first thing in the morning, followed by the probiotic about an hour later before I left for work. Then around 3pm I would take the second dose of the antimicrobials, and the probiotic right before bed.

I just had a follow up appointment with Dr Ruscio about 2 weeks ago, and he also had me add in 60 drops of Iberogast before bed. It’s a liquid blend of herbal extracts that help with gastric motility. I had tried it before in the past but not such a high dose, and had mixed effects. This dose does seem to be making a difference. I’ve been using it for about a week now, and the past couple of mornings I’ve actually woken up with a flat stomach- no bloating! That is quite nice.

I re-do my SIBO breath test tomorrow, so that means I have to eat the restricted diet today (which I am not looking forward to!) , and I also have to re-test the Doctor’s Data test. I waited too long to book my follow up appointment with Dr. R, so I won’t get those test results until July. Like I said before, I’m pretty happy with how the treatment went but I am SO GLAD for it to be over. It was really starting to take a toll on me psychologically, with all of the pills and the timing and what not. I am just pretty fatigued from “treatments” at this point and I want to not have to worry about it for awhile.

I have a sneaking suspicion the SIBO will return, but I’m trying not to worry about it and keep doing the strategies that I know help- eating low FODMAP when symptoms flare, taking the Iberogast, avoiding gum chewing and sugar alcohols, avoiding certain types of fiber, and continuing to take the expensive probiotic.

Ok, now for the side effects.

I can’t say for sure these were a result of the treatment, but I think they are worth mentioning.

  1. My leaky gut seemed to get worse. I can tell because I react to foods more easily and my skin is all kinds jacked up. I’m getting red blotchy patches from certain foods and sunlight, and flares in blemishes on my face. Also I’ve noticed some wrinkles developing on my forehead. I’ve still been taking my zinc carnosine and I added in glutamine power. And I still drink my bone broth, so that all hasn’t changed. But I feel like I’ve taken a step back in the healing of my gut.
  2. I’m having some major muscle pain and weakness. I really haven’t had any exercise tolerance at all, and even walking leaves me sore and tight. This has been most upsetting for me, as I’ve need to exercise for my mental health, but being in pain both from exercising and from not exercising is an awful thing. And it’s not like I’m exercising hard, either. I’m just talking about walking. I can tell my body is inflamed.
  3. My fatigue has been worse.
  4. Ok, now for a good effect- my female hormones seem to be balancing out. I had my cycle again for the first time in two years. Granted, this was also coupled with a cessation of restrictive eating and intense exercise, but I do think healing the gut has helped, along with the female hormone balancing herbs Dr. R put me on (Phytoest and Phytoprogest).

Ok, that’s it for now. Generally, I do think the protocol has been helpful and I think it was worth it despite the side effects I noticed. With that being said, I’m looking forward to NOT taking any more antimicrobials for awhile, and just focusing on healing my leaky gut and other parts of my health for awhile. And maybe have some fun, too. 🙂


New SIBO doc: Tests and Treatment Plan

In January I had my first Skype appointment with Dr. Ruscio. I had been following his work and podcasts for the past 6 months or so, after first hearing him as a guest on the Robb Wolf podcast.

Though he is a chiropractor, he specializes in thyroid and gastrointestinal disorders and is an expert in SIBO. It’s clear he stays up to date on the most current literature on GI issues and is implementing the most relevant and researched treatment techniques in his practice.

So after a month or so of wait, I finally had my appointment. Prior to it I had to fill out an extensive health history form and current symptoms questionnaires. It was clear he read through them prior to our first appointment, but I was a bit surprised as to how short the initial consult was. I suppose I thought he was going to ask more questions, but it was only about 30 minutes long (after waiting an extra ten or fifteen minutes as he was running late.)

The next appointment was the following week and he presented his review of findings and testing and treatment plan.

Here’s what went down:

He believes that many of my systemic symptoms are resulting from my GI imbalance, with which I agree. (I do think there’s something else aside from my GI issues contributing as well, but I don’t know exactly what.)

So the first plan of action was to redo the SIBO test and see the results of that. Based on my symptoms I’m pretty sure I still have SIBO, but am very interested to compare it to my prior test.

Next, I had two different stool tests to do, and h.pylori breath test and an extensive panel of blood work.

After I completed all the tests I could start the first part of the treatment plan. It has three parts: Adrenal support, female hormone support and gut support.

For the adrenals: supplemental pregnenalone and DHEA. These are hormones produced by the adrenals that are precursors to many other hormones including estrogen, progesterone and testosterone.

For female hormone support, I’m taking Phytoest and Phytoprogest. These are herbal tinctures that supposedly balance female hormones. I haven’t read enough about these herbs yet to know what science is behind them. (As a side note, they are amazing bitters so they actually help with digestion as well!)

Finally, for gut support he wanted me to start with a modified fast of sipping either bone broth or a master-cleanse type drink for a day or two or whenever my gut symptoms flare up. I tried to do this but my blood sugar crashes so hard by the afternoon I just cannot go without food for a whole day. But even modified-fasting until noon or two and eating mostly fat and protein the rest of the day does help.

After the modified fast, he wanted me to implement any parts of the Specific Carbohydrate Diet I wasn’t already doing. I was already doing most of the SCD recommendations.

Lastly, the gut supplements. A digestive enzyme with betaine HCL and ox bile, Therbiotic probiotic and a Saccharomyces boulardii probiotic.

He wants me to discontinue my other supplements unless I find them to be especially helpful, so I’m continuing to use my YST management enzyme, zinc carnosine, vitamin C, magnesium, and my sleep supplement. As well as a few other products that I use “as-needed”.

I’ve finished all of the testing an am waiting on some of the results. I’ve implemented all of the supplements except the Saccharomyces, but I’m not quite at the recommended doses for everything yet. I like to take a gradual approach when I introduce new things so I don’t overwhelm my system. I should be at the recommended dose for everything by the end of this week.

One thing I have noticed so far is a good deal less bloating and better regularity when I take the Therbiotic at night.

My next appointment with Dr. Ruscio is in 3 weeks, and we’ll go over my test results and how the treatment plan is working so far.  I’ll be sure to keep you posted.

Have any of you tried any of those supplements, or worked with Dr. Ruscio? Let me know in the comments!

Adrenal Fatigue, Coffee and Exercise: Finding Balance


I wiped out my adrenals first about five years ago. I had just started my new “real” job in the city, had a close to two-hour-each-way, stressful commute everyday, became hyperthyroid and wasn’t eating enough. Coffee was my crutch, and my one cup a day habit quickly morphed into a steady stream of java all day long, at least until 4pm.

When I learned about adrenal fatigue and first saw a naturopathic doctor that could do testing, my  cortisol levels were pretty much a straight line. My adrenals weren’t completely destroyed, but there was not dramatic rise in the morning and fall in the evening like there should be.  

After a long, long time (about 3 years) of trial and error, I finally got my energy levels back to perhaps 80% of what they should be, and I decided I to sign up for something that had always been on my bucket list as a runner: a half marathon.

I chose the Ocean City half that goes from Assateague Island to the inlet, a nice, flat run. Literally no hills except for the bridge when you cross from Assateague to the mainland.

I began my training, working up to  about an hour/hour and a half  everyday with long runs on Saturday. I didn’t follow a training plan, but I outlined the minimum number of miles I needed to do on my long runs to prepare.

As a type-A overachiever, I always did more. I overtrained, I didn’t take enough rest days. If I didn’t run one day, I felt guilty. And I still likely didn’t eat enough, but sugar, carbs and caffeine increased as I looked for ways to fuel my runs.

During the height of my runner’s highs I thought perhaps I’d actually train for a full marathon, and just use the half marathon race as practice. Two weeks before my half, I ran 18 miles on my  long run. I barely tapered before my race.

At this point, a runner might expect me to say I crashed during the race, or didn’t hit my goal. Actually, I beat my goal by 12 minutes, and gained speed during the last six miles, passing a hundred or so people. I could have started faster.

I took a minor, couple of days break from running and tried to get back at it.

But then something happened. I just couldn’t. I reached a point of physical and mental burnout and my body would literally not let me run.

I could barely walk.

What followed was about a year of adrenal exhaustion and exercise intolerance. I knew running was not what my body needed, so I began to weight train to keep lean muscle mass, and switched to just walking. Some days, my 20 minute morning walk would leave me exhausted.  

I knew coffee was playing a part, so I limited myself to one travel-size mug during the week and tried to stop drinking it by 2pm, 3 at the latest.

Insomnia had also been playing a huge part and I finally made some progress on getting sleep. I’ll cover that in another post.

Somewhere during this I switched to the Paleo diet, upped my fat intake and upped my protein intake. My body loved this.  

First, a miraculous thing happened to my brain. I started having moments of clarity. The fog was lifting. Not every day, and not all day, but it was happening.

Then, I found my body telling me I could start moving it more, but it was limited. I made gains in my weight training.  A few times in the past couple of months I tried running. Each time, I could go for a few minutes and then felt I needed to walk.

One of the worst things about trying to balance adrenal fatigue, chronic fatigue, and a need to exercise is truly listening to your body.

Was my body telling me to actually stay in and sleep because I needed it, or was I just being lazy and the blankets were warm?

Some mornings, I would get up, put on my workout clothes and have a 10 minute mind battle with myself where I tried to discern what I should do. I still struggle with it, I did this morning.

But a couple of weeks ago, something told me “run”. Part of it had to do with my mood, which was pretty low. “You’re much happier when you run,” Alex told me. I knew he was right. Walking and weights just didn’t improve my mood like running did.

So the one day I got the urge to run, I did. And I ran for 30 minutes straight. I felt good. The next day, I did the same. Soreness occurred, of course, but the exercise intolerance I had before was gone. I’ve been running again ever since.

Right now, I’ve limited myself to 30-35 minute runs, only 2-4 times per week. I’m making sure my coffee and sugar habit stay under control and am getting enough sleep. The last part that I need to take care of to really make sure I keep my adrenals healthy is stress relief, but that’s been the most difficult so far.

Anyway, if anyone reading this is struggling with adrenal fatigue, please be patient with your body. It took me over three years the first time and over a year the second time to get my adrenals back to almost normal. The second time I had to do very little cardio exercise and incorporate dramatic diet and lifestyle changes.

Listen to your body. It will tell you what it needs.


Zinc for Leaky Gut

The systemic symptoms of SIBO are very real.

Fatigue, joint pain, brain fog, headaches and even depression and anxiety can all be caused when the body mounts an immune response against endotoxins and foods that have entered the blood stream.

In a healthy gut, only select nutrients are allowed through the tight junctions of the intestines. But during SIBO, the bacteria can damage the intestines to the point where it actually becomes more permeable. Then, the bacteria can enter the bloodstream along with food particles and other toxins that are ingested.

Once in the bloodstream, the immune system mounts an attacks against the foreign particles and can cause a wide range of symptoms.

Foods that have never bothered me in the past can now wipe me out with brain fog, fatigue and anxiety.

When the gut is too permeable, there’s usually not just one or two food intolerances. All food can be problematic.

If you have SIBO, noted food intolerances, or chronic inflammation, you almost surely have a leaky gut. I discuss the connection between leaky gut and heart disease in this post.

The first thing to do is avoid things that can increase gut permeability. I’ll cover this more in another post.

Then, there are some specific nutrients that have been shown to be extremely healing for the intestinal lining and can help protect against and even repair a leaky gut.

Bone broth, glutamine, and the topic of today’s post: Zinc.

Zinc is absolutely crucial for immune function and cellular repair, yet most people aren’t getting enough.

And a specific kind of zinc, called zinc carnosine, has been shown in multiple human studies to be beneficial to the lining of the GI tract. It’s been shown to help heal stomach ulcers, inhibit h. pylori, prevent heartburn and acid irritation, and relieve gas and nausea.

It’s also extremely effective at keeping the small intestine healthy.

One human study showed that zinc carnosine  prevented the increase in intestinal permeability caused by NSAIDs. Another human study demonstrated that it repaired damaged to the small intestine.

It really is a powerful nutrient. In fact, its actually used  a prescription in Japan as a treatment for stomach ulcers.

I started taking zinc carnosine about three months ago and I’ve noticed a  very marked improvement in  some of my gut symptoms. But mainly, I’ve noticed a major improvement in the systemic symptoms I was getting.

My fatigue has improved, my headaches are less frequent, and food doesn’t always make me extremely tired or cause massive brain fog like it used to.

I don’t always remember to take it every day, but I always take it if I know I’m going to ingest any alcohol that day, since alcohol has been shown to be extremely damaging to the gut lining. It seems to have helped improve my hangovers, too, since not as many toxins are getting into my bloodstream.

I’ve also noticed that my skin is breaking out much less than it used to because less toxins are getting into my system and trying to detox through my skin.

If you’re suffering from SIBO or systemic issues that could be caused by a leaky gut, I highly recommend you give zinc carnosine a try.

I use the Pepzin GI brand and I get it from Vitacost, they have pretty good pricing.

Tomatoes and Joint Pain

The past couple months I’ve been experiencing some joint issues that have made me worried. Mostly stiffness and popping joints, but also knee and elbow pain.

It crept up on me so until I really thought about it, it seemed like ones of those symptoms that had “always been there.”

But then, I tried to start running again and my knees just about gave out on me. Intense pain and stiffness after doing only a few miles.

It was time to investigate.

I had written an article about nightshades and joint pain for Living Well Daily and I had tried cutting out nightshades before with no real noticeable difference. However, I wasn’t super strict as I found it extremely hard to avoid peppers in seasonings due to eating out frequently.

Then I read/heard on a podcast (they all blend together sometimes) about how tomatoes especially can aggravate joints.

I took a look at my diet and realized I had been eating tomatoes every day for the past several months, and almost every day for the past year or so. My lunch was typically chicken/tuna/salmon mixed with avocado and tomato.

So what the heck, I figured I’d cut them out again along with all nightshades  and see what happened.

I was doing good for a week and then came across an extended list of nightshades that had one on it I hadn’t seen before- goji berry.

And of course, I had just started taking an all-natural vitamin C supplement that was made from berries- including goji berry.

So I cut that out too.

It’s been about three weeks now and my joint issues are incredibly improved. I still may be consuming some chili pepper spices here or there, but I think cutting out the tomatoes and the goji berry are making a huge difference. My knees feel a lot better, I’m 80-90% less stiff, and the popping is much improved.

As far as why tomatoes and nightshades can aggravate joints, I won’t go into much detail right now. You can check out the article I wrote here for a bit of the science, but mainly, it has to do with a leaky gut.

And my gut is basically a sieve.

I’ve been experiencing increasing symptoms of leaky gut and reacting to foods I’ve tolerated in the past.

So it’s about time to really start diving into a leaky gut healing plan.

Glutamine has made it’s way back into my daily supplement regime, and I’m researching the best ways to heal my intestinal permeability, including the autoimmune paleo protocol.

My SIBO has also flared up again and I know that can greatly contribute to a leaky gut. I had some Candibactin AR and BR left over from when I did the Johns Hopkins herbal antibiotic protocol, so I figured I’d finish off those bottles and see if it helped at all, while I pay down my credit card enough to have some money to go see a SIBO specialist.