Lately I’ve been asked by several people about what treatment I did to get rid of SIBO so I decided it was a good time to summarize so I have it in one place. Now keep in mind, what worked for me may not work for you since it seems that everyone is different when it comes to SIBO. I also had methane (CH4) dominant SIBO and didn’t show any hydrogen (H2) until my CH4 numbers were way down but having CH4 means you have H2 underneath since the m.smithii methanogens eat the hydrogen gas created by the other bacteria to create CH4.
My initial attempt at treatment was with prescription antibiotics. I did 1600mg Xifaxan and 1000 mg Neomycin for a whopping 4.5 days before the side effects made me stop. I’m still dealing with those side effects 2 years later and expect to have them for life at this point so I am not too fond of this approach and since studies have shown herbals to be just as effective if not more effective and much safer. Still, even with only 4 days it took my levels from a high of 44ppm CH4 down to a high of 8 ppm CH4 and 8 ppm H2 which was technically a negative test, my CH4 only rose 1 point above baseline and same with my H2.
That didn’t last long although I’m not sure I was feeling bad from SIBO or from the drugs but the SIBO came back with a vengeance and was actually worse than my initial tests with a high of 49 CH4 and 4 H2. Then I began herbals and did 2 months of AlliMed, Neem and Berberine. My dosing was 3x a day before meals using:
This combo took my numbers down to a high of 10 CH4 (rise of only 2 ppm) and 2 H2, a flat line. I relapsed again after this and had to repeat the whole thing another 2 months to get back to basically the same point. In this second cycle I added in berberine and prokinetics so did:
- 2 AlliMed 3x a day before meals
- 2 Neem Plus 3x a day before meals
- 1 Berberine Complex 3x a day before meals
- 20 drops Iberogast before meals
- 3 MotilPro (well, a homemade version) at bedtime
- 4.5mg of LDN at bedtime
Each time this combo took me down about 40 ppm in CH4 which is pretty much on target for what the SIBO Center has found to be the average effectiveness for herbals or prescription antibiotics, a drop of 20ppm per round of treatment.
I decided to keep treating at this point to see if I could get the numbers all the way down since I still wasn’t feeling great. I changed up protocols and did 2 weeks of CandiBactin-AR and -BR. I did 2 caps 2x a day of each at breakfast and dinner. This actually raised my H2 count from 2 to 14 ppm and even slightly raised my CH4 to a high of 11 (rise of 5) so I’m not sure it did any direct good on SIBO but suddenly I could eat more foods.
After that I did the Biotics Research protocol, the big one throwing everything at it in hopes of wiping out the SIBO and the blasto I had. This one was a LOT of pills, for two weeks at a time I did the following at each meal:
- 5 ADP tablets
- 1 Berberine HCL capsules
- 2 Dysbiocide capsules
- 2 FC Cidal capsules
I’d do this 2 weeks then a week of Sacchromyces Boulardi 1 cap/2x a day then repeat this cycle 2 more times for a total of 8 weeks of treatment. This dropped my CH4 back to a high of 8 (rise of 4) and my H2 down to 7 so it did a bit of good but it killed my blasto which was huge. During these last two protocols I continued with the prokinetic regime I had started earlier.
I stopped chasing numbers at that point since my colon had so much m.smithii that I would never get a 0 baseline and probably never get a true negative test so I decided the best approach was to add in fermented foods and probiotics to try and crowd out the the bad guys. I had re-read The Gut Health Protocol at the same time and decided that this approach made sense. I started with 1t of sauerkraut juice per day and slowly added until I got to 1T of juice. Then I did 1T of actual kraut and kept slowly increasing until I got to 1/2 c. per day of either kraut or kimchi. I make my own to get the most microbial diversity in my ferments plus it is a lot cheaper. I also added in some kombucha during this time. Then I started on probiotics, using CustomProbiotics powder so I could begin with the baby spoon and again very slowly increase until I got to the adult scoop. This seemed to do the trick, after a few months of fermented foods and probiotics my poop got back to normal, I was no longer dealing with constipation and most of my gut symptoms had vanished. I’m still awaiting test results to see if my crowd out theory is working but already my colon microbiome is looking better than before.
I continued on prokinetics for 3 months after stopping treatment to prevent SIBO from coming back and then I slowly began dropping them. I started by cutting the Iberogast out at lunch then breakfast and finally completely. I then began slowly cutting the MotilPro from 3 to 1 capsule before stopping it. I’m still on LDN and will cut the dose down to 3mg next month but plan to stay on it to keep the EBV at bay and 3mg seemed enough for that purpose.
During my long treatment phase I was sticking to a low FODMAP AIP diet most of the time which made me feel best though probably dragged on the treatment phase since I wasn’t actively feeding the bacteria and not as efficiently killing them. It also had a negative impact on my colon since I had no good fermentable fiber for the good bacteria to eat and thus no butyrate or short-chain fatty acids left in my system which is bad. Hoping that the ferments, probiotics and now full Paleo diet shift that back to normal. If I had to do it over again I’d eat more FODMAPs while treating and just limit the low FODMAP diet to after treatment to try and avoid relapse.
Other factors played a role too for sure, what I’ve learned are “Primary Foods” in my IIN training. I took up meditation again when I was sick and sitting daily again plus chanting really helped calm my mind and body and change my outlook on the illness. Having support from my wife and family was huge for me, kept me going forward at all times. Finding some fun in every single day was important even if that meant nothing more than going outside and lying on a blanket looking at the birds for an hour or so, some days that was all I could manage. Once I was able to do any exercise I started slow with walking, then hiking and then running again, it really helped my body recover and made me feel so much better. Breathing exercises to stimulate the vagus nerve also seemed to help as I think my brain-gut connection was short circuiting for a long time.
I also think that the ferments and probiotics were crucial in getting me back to health and had I added them sooner maybe this would not have taken so long to treat. I do believe you need to get your numbers down somewhat before adding these in but I think they are important and for too long I listened to the SIBO Center recommendations never to add them in and that held me back. I’m now at 9 months without any relapse and am eating the best I’ve eaten in several years, probably the best I’ve eaten in my life really, and I have no real SIBO symptoms left. Yes, my gut is still a bit sensitive and I am avoiding gluten and dairy but I eat very well and have a full life again full of energy.
This PDF has a summary of the protocols that I have tried or have real studies done on them. There are other protocols out there now that people are using but I haven’t had any direct experience with them nor have their been studies done on them.