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 Protocol Update

Here’s a quick update on my most recent SIBO protocol with Dr. Ruscio.

He ordered a bunch of different gut tests, looking for specific infections like parasites, bacterial dysbiosis and  candida, as well as signs of inflammatory bowel diseases or celiac. I also did another SIBO breath test.

While we waited for those results to come in, I started taking Ther-Biotic Complete probiotic powder. He also wanted me to take enzymes with betaine HCL, which I did initially, but it caused stomach pain so I discontinued them.

Lastly for the gut, he wanted me to take Saccharomyces boulardii.

I like to gently introduce things into my system so the saccharomyces was the last thing I planned to introduce. However, I started noticing some really positive effects from the Ther-Biotic, including less pain, bloating and better regularity. So I never actually added in the saccharomyces before our next appointment.

I was feeling really positive at our follow up appointment, as my gut was doing a LOT better. We went over the tests- nothing came back showing a serious issue or infection, so that was good. I still had a mild case of SIBO, with both hydrogen and methane gases showing up, and a bit of gut dysbiosis with some candida.

So, he started me on a “gut bug” protocol (as I like to call it). Here’s what it is:

First month:

Oregano oil

Atrantil

Gi Microbex

Second month:

Atrantil

OrthoFlora Yeast

ParaBotanic Select

He also asked me to start taking the saccharomyces.

Well, I’m about at the end of my third week of the protocol and I am NOT doing so great. My gut symptoms have returned and I’m feeling pretty miserable. I can’t pinpoint if it is the saccharomyces or the whole protocol, but I’m a bit discouraged that I seem to be regressing rather than getting relief.

However, I do know that something things can get worse before they get better, and I’m only about halfway through the protocol. Plus, before I started it, even though I had been doing better, I wasn’t fully healed and still needed to make improvements. So I’m planning to stick with this protocol until the end and hope it makes a turn here soon and I start getting relief.

I’m still taking my YST enzymes before I eat, though they don’t seem to be having as a great of an effect as before. I am also still taking my zinc carnosine, and I added in vitamin D3 and K2 since my D3 levels were low. And I still take my magnesium at night.

As for the protocol itself, it’s really an interesting mix. Atrantil is a new product on the market and has one human study on it showing relief from SIBO symptoms, but I don’t think it a particularly robust study.  Gi Microbex is a mix of herbs that all contain berberine, and the other two products for the second month are a solid mix of antimicrobial herbs. It’s a similar protocol that I used when I followed the protocol used in the Hopkins study, but with the addition of the Atrantil, and going for double the length of time.

If anything changes dramatically, I’ll be sure to post sooner rather than later.

Have you tried any of these products or a similar protocol? Let me know!

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!

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.

Enzymes for SIBO…or maybe its SIFO

I’ve been having good symptom prevention lately by taking candida-fighting enzymes. Specifically, YST Management from Vitacost.

It’s a combination of enzymes that supposedly digest candida and break down it’s cell wall so that the immune system can attack and remove it.

I had used these enzymes a couple of years ago when I thought I had candida overgrowth. I didn’t notice that they did much.

But, since they are powerful enzymes for digesting cellulose and other carb and starchy things, I thought they would be good to take before I eat vegetables, to help prevent the bloat, and they are working quite terrifically for that. Much better than any other enzyme supplement I have tried (and I’ve tried many!)

I also take two in the morning with water or my green juice to try and attack and candida that may be there, just in case.

I’m actually have such good symptom relief I’m wondering if I have a case of small intestine fungal overgrowth (SIFO), in addition to the SIBO.

The NOW peppermint gels have still be working for me as well, for the most part, and the combination of the two have really helped me live a nearly symptom-free life for the past couple of weeks.

New GI Doc, New (Old?) Disappointment

Welp, I shouldn’t really be surprised. After all this is an old, conventional MD. But still, he came with good recommendations so I had high hopes.

He came out to get me right at 2pm, my appointment time, which was a great start. He listened to my history and asked a good deal of questions. But then, the fatal statement that proved to me he was not up to date on SIBO research.

“I don’t believe you have SIBO because you aren’t having diarrhea.” He said this, mind you, right after looking at my lactulose breath test results showing a significant rise in both hydrogen and methane production. “I think all of your issues are due to the fact your bowels are not moving.”

At this point, I had two options.

  1. Try and educate him on SIBO-C, methane, and how to properly read a breath test, or
  2. Don’t bother with the above and listen see what he had to say about improving bowel motility.

I quickly assessed my options and went with number two.

I just can not seem to make myself an authority figure to doctors. For the most part, I know what I’m talking about. I’ve done the research. I even bring the studies with me to the office! But as soon as they say something that proves to me they haven’t read the latest research, I tend to think all is lost and there’s no point in educating them as they aren’t likely to change their minds anyway.

So I listened as he gave me the same information I’ve read on the internet as thousand time (eat more fiber, drink water, exercise, take fiber supplements and a laxative if needed). I tried to explain I’ve done all that (I was running an hour a day last year, same issues. I drink so much water I pee almost every hour. I have eaten up to 50 grams of fiber a day with no improvements. Ahhhhhh!!)

I told him I didn’t want to take a motility drug because I wanted to know why my bowels have stopped moving. The human body doesn’t just quit functioning properly for no reason. There’s always a reason!

Also, I am only 27. If I started the drugs now, it’s likely I’d have to take them for the rest of my life, which I hope to be for quite a few more years. And I don’t want that.

While he was very understanding about those concerns, he didn’t really have anything else to offer me. He said to try some of his recommendations and call him in a month.

He did offer me one solid piece of advice that I think may play a big part, if only I can implement it: Relax and have fun!

Stress can mess up the bowels, big time. And I’m certainly always stressed. Even though I love my job, my boyfriend, and my life as a whole is not stressful, I put so much stress on myself. To lose weight. To look better. To exercise better. To learn more. To do this, do that. Be creative, keep the apartment clean, find a house, where to live. I even stress myself out to have fun!

But even though I know stress is a part of it, it is not the whole of it. I still think SIBO and impaired colonic motility are a problem that needs to be fixed.

So here’s where I am now:

Luckily, knock on wood, the peppermint/fennel/ginger gels are still preventing most of my bloating and abdominal pain symptoms if I take them before a fibrous meal. The problem? They are giving me a false sense of hunger, so I am noticing I am eating more. And my weight is starting to creep up again. That’s unacceptable to me, (as well as another source of stress!)

However, I am going to continue with that supplement and try to keep my eating under control. I am also considering doing another round of herbal antibiotic protocol in conjunction with the peppermint gels. I don’t think it will hurt, and I also want to use up the remaining product that I have. Then, my plan is to get my functional doc to order another breath test so I can see where I am at.

If at that point I am still having symptoms and the breath test is positive, its time to bring out the big guns and find a SIBO expert, even if I have to go all the way out to Portland to do so.

If things are improved or the test comes back negative, then I’ll work on repairing and rebuilding my gut.

Until then, I am going to continue with the diet that I’ve been doing, but I think I may need to bring my protein intake down a bit and increase the fat intake. I’m considering adding collagen protein in the morning.

I might try a fiber supplement and see how that goes, though I have a strong feeling that my gut won’t care for it.

SIBO and Weight Gain

I gain weight very easily.

It seems I’ve been on a diet all of my life, and to some extent I’ve likely messed up my metabolism quite badly. I have to eat very low calorie and maintain and exercise regime to keep my body at the weight and shape I prefer.

Essentially, I’m fighting my set point. And its hard. But it’s a choice I’ve made.

With SIBO, though, it seems like I have to try even harder to keep my weight down. And when I do slip up and eat more than usual, my body stores it as fat immediately.

And now, I’ve come across some research that may explain what’s going on with that.

There are two types of organisms that are predominant in SIBO- hydrogen producing bacteria and methanogenic producing archaea.

And a study on nearly 800 subjects published in 2013 found that subjects who tested positive for both elevated hydrogen and methane levels had a significantly higher BMI than subjects who tested positive for hydrogen or methane alone. I have both hydrogen and methane producing organisms in my SIBO.

In a previous study by the same researchers, they found that subjects who were methane-producers had a higher BMI than people who were not methane producers (hydrogen was not tested).

And finally, a animal study demonstrated that when germ-free mice were colonized with a particular strain of methanogenic archaea called Methanobrevibacter smithii, they gained more weight than other mice.

M. smithii is the most abundant methanogenic archaea in the human GI tract, and appears to be the predominant species in methane-positive SIBO.

The researchers hypothesize the reason for the increased weight in humans may be due to this:

M. smithii feeds on hydrogen gas to produce methane.

Normally, hydrogen bacteria are self limiting. Once they create a particular amount of hydrogen gas, they get a signal to stop eating.

But if M. smithii is there eating up the hydrogen gas, the hydrogen-producing bacteria continue to ferment food and produce more hydrogen.

But that’s not all they do.

Hydrogen bacteria also synthesize short-chain fatty acids that you (the host) use as fuel, and they also make calories more available.

In essence, they help you get the most calories from what you eat.

So someone without SIBO may only absorb 75% of the calories from a particular food, but a person with SIBO may absorb 90%, and therefore need to consume less food overall to maintain caloric balance.

This hypothesis isn’t proven, and it’s likely there are more factors involved such as hormone dysregulation and metabolism dysregulation.

But it’s an interesting idea and it seems to make sense based on my experience.

So its at least good to know my struggle to keep my weight down since getting SIBO isn’t all in my head. And there are a number of folks out there that sees to have weight issues with SIBO as well.