For some reason my middle of the night insomnia is back with a vengeance after a few months of really good sleep. I fall asleep easily every night but wake up somewhere between 11:30-12:30 and then cannot get back to sleep until about 3:00 when I will grab a few more hours of sleep. Needless to say, I’m tired after a week of this. It sure seems like my cortisol is jacked up again since I’m feeling more anxious on top of not being able to sleep. So, tonight I go back on sleep restriction and see if I can get this back into a better pattern like I did last time around. Other than that all is good with regards to SIBO as I’ll be at 7 months on Monday since I stopped treatment with no relapse!
Category Archives: SIBO
Small Intestine Bacterial Ovegrworth, or SIBO, is a chronic bacterial infection of the small intestine that I have been dealing with since the fall of 2013. These are not necessarily bad bacteria and are typically beneficial bacteria but they have moved up from the colon into the small intestine where they interfere with digestion and damage the lining of the intestine causing leaky gut syndrome and possibly auto-immune disorders. In my case I quickly developed a severe gluten and casein intolerance, peripheral neuropathy in my feet and malnutrition/vitamin deficiencies that contributed to a sharp drop in weight.
Symptoms of SIBO include abdominal bloating and pain, constipation or diarrhea, and a feeling that one is basically allergic to food, especially carbohydrates. Many other symptoms are also possible depending on the severity. With leaky gut one can have fatigue, food sensitivities, headaches, and “brain fog”, I had all of these at the beginning. With malabsorption syndrome one can have weight loss, I lost close to 35 pounds in a matter of a few months. If left unchecked SIBO can lead to many auto-immune disorders or fibromyalgia.
SIBO is found with a lactulose breath test which measures the levels of hydrogen and methane in your breath. These gases are not created by our human cells and can only be present if bacteria are producing them. The test, spaced at 20-minute intervals over a 3 hour period can pinpoint where the bacteria are located in the small intestine.
SIBO is typically treated with one or more rounds of antibiotics, usually Rifaxamin and, if you have methane producing bacteria, Neomycin or Flagyl. These antibiotics were too strong for me and I was in the unlucky 10% that experience severe side effects and I had to stop taking them before the full course was done. Instead I had to use multiple rounds of herbal antibiotics – AlliMed and Neem Plus – to start to drop the bacterial levels. I have also been using Metagenics CandiBactin-AR and -BR as well as FC-Cidal, Dysbiocide, ADP and Berberine HCL from Biotics Research. Diet is also important in controlling SIBO and one must stick to a low FODMAP version of the Paleo or Specific Carbohydrate Diet. The diet that worked best for me was developed by Dr. Allison Siebecker at the SIBO Center in Portland and it is SIBO Specific based on a low FODMAP version of SCD.
Some resources for those dealing with SIBO that I have found helpful include:
- SIBOInfo.com – site maintained by Dr. Allison Siebecker
- Natural Functional Medicine – site of Dr. Melanie Keller, also of the SIBO Center, who I see via Skype.
- SIBO: Often-Ignored cause of IBS – good overview article by Drs. Siebecker and Sandberg-Lewis of the SIBO Center.
- Sibo Support Group – We Cured It and So Can You on Facebook
- SIBO Discussion/Support Group on Facebook
- Western Washington SIBO Support Group – Facebook group for a local SIBO support group I am trying to put together. We are trying to meet once a month locally. If you want to join, send an invite from the page and I’ll add you assuming you live in the Puget Sound region.
SIBO App – I developed this iOS app in conjunction with Dr. Allison Siebecker of the SIBO Center. It includes an interactive version of her SIBO Specific Food Guide which can be searched, sorted and filtered. Free on the AppStore.
The following blog posts cover my ongoing journey with SIBO from the beginning.
A lot to be thankful for
First turkey, Thanksgiving 2014
Two year ago Catherine and I ate Thanksgiving dinner at our favorite restaurant, Cafe Flora, and I felt like hell. I’d been dealing with gut issues ever since August when I took some antibiotics for a prostate infection. After doctors were no help I self diagnosed it as a candida problem so we celebrated Thanksgiving and then went on a hard-core candida cleanse the next day so I had a month from Thanksgiving to Christmas. It helped but I ended up really sick after Christmas which began my whole journey into the world of SIBO. Last year at Thanksgiving I was still not too well and had just suffered another relapse. Still, compared to 2013 I was doing a bit better after finally getting a diagnosis, totally changing my life and treating SIBO for about 4 months with herbals.
First weight goal met!
Back when I started Operation Bradley Cooper in August I had set an interim weight goal of 160. Today I finally crossed that goal for real, my first morning weigh-in above 160! This is huge, I dropped below 160 way back in January of 2014 and never got above it until today. It is good to see a steady climb since July in my weight. Now I just need to keep eating well, working out and things should settle out in the next few months to where my new normal weight is. Hoping I can get enough muscle to get it back up to around 165, just want to avoid putting it all on my belly.
Tracking my microbiome
During my whole SIBO journey I did two stool tests to see what the heck was going on in my colon and I know all of you are curious about that too. The tests I did so far were the Genova GI Effects Stool Profiles which are not cheap but were useful since the one in Sept 2014 identified the fact that I had a blastocystis homins infection, a moderate imbalance with too many pathogenic bacteria, too few beneficial bacteria and too low of levels of butyrate and short chain fatty acids (SCFAs). I had almost no Lactobacillus or Bifido species and way too much m.smithii, e.coli, and a few other nasty critters.
67 miles in 6 days and weight went up!
I just got back from a week of vacation in sunny Southern California where I took advantage of the perfect weather and did a LOT of walking and running. I managed to run three mornings in El Moro Canyon for a total of 15.5 miles, Catherine and I did several long beach walks at Crystal Cove clocking in 22 miles and then just normal life and playing with the niece and nephews on the beach or at the resort got us another 5 miles per day for a total of about 67 miles for the week. I figured that I was probably going to come home down 3-4 lbs after my experience in OR and the North Cascades but I got home and weighed in at 161, up 2 lbs from when I had left. It’s not like I pigged out while in SoCal either and I really didn’t have lunch the day we traveled home so to me this is a good sign that my weight issues are behind me and that I can just continue eating a good Paleo diet and probably keep slowly gaining until I hit my real weight somewhere around 165. On top of that I made it through the week w/o any symptoms and even dined out at restaurants a few times during the trip and ate onions every morning with the breakfast hash I made.
Weight came back to new high
I managed to drop quite a bit of weight during my two weeks of outdoor vacation steelhead fishing on the Deschutes and hiking all over near Mazama but it rebounded very quickly this time around and this week I hit a new high of 159!!!! This is the most I’ve weighed in several years. I hope that the 160 mark isn’t too far away, I’d like to get there and really I’d like to be back around 165 which was my best shape weight.
Meatless Mornings
After 20 months of meat at every meal I’m finally to the point where I don’t need it at every meal so I’ve been instituting Meatless Mornings quite a bit this last week. Eggs are what saved me, once I could eat them daily it opened up my possibilities for breakfast meals that didn’t have to include a sausage patty or bacon. I was in a total run on the basic AIP Scramble which had been my staple breakfast item for about a year. This week I’ve gone meatless about half the days and here are a few of my breakfasts from the week:
Scramble with chanterelles and asparagus with sweet potato hash browns, a banana and a coconut milk latte. It is so nice to be able to eat mushrooms again, just in time for chanterelle season in the NW since they are one of my favorite mushrooms. A few days before this I had a scramble with asparagus, zucchini and button mushrooms.
Another good SIBO post
This must be the week of good SIBO posts because here is another that was going around on various Facebook pages – Why Diet Alone Is Not Enough to Treat SIBO. This is another post that I wish I’d read two years ago since I spent a LOT of time on the low FODMAP diet while taking herbals when I probably should have been pigging out on FODMAPs at that time and saving the low FODMAP for after I eradicated the little buggers. Instead the 18 months on low FODMAP caused the current imbalances I’m dealing with in my colon.
On that front, I have added in more good food for bacteria this week. I made nomato sauce yesterday with the full dose of onions and garlic for the first time and seemed fine with it. This morning I made banana flour pancakes, green banana flour is a great source of resistant starch and so far so good on that front. Hopefully between the addition of more FODMAPs in my food, the probiotics with potato starch and the fermented foods I’ll build back up my colon flora and get my butyrate and SCFA levels back to normal in the next 6-12 months.
Good reading for those with SIBO
Here is a great post by Riley Wimminger entitled Words of Wisdom for SIBO Newbies that I really wish I’d been able to read two years ago when this whole SIBO journey started, it has some great advice on how to hang in there for the long haul.
On the point about restricting your diet only as much as needed, I was talking with Dr. Keller yesterday and this point came up in our conversation. She recommended no one stay on the super restrictive low FODMAP diet longer than six months since it does mess with your microbiome. Of course I was low FODMAP for almost 18 months so it is no wonder that my butyrate, short chain fatty acids and microbial diversity are all a bit out of whack. It is a challenge for those whose SIBO won’t clear within six months though, what to do to keep the microbes happy yet also keep the symptoms down, a balancing act for sure.
Paleo now, no longer low FODMAP AIP
In the last few months my diet has expanded quite a bit to where I no longer consider myself eating AIP (Autoimmune Protocol) but instead am eating a pretty full Paleo diet. I added in eggs first about six months ago and have been slowly expanding with some nuts and seeds. I’ve also stopped the low FODMAP portion of my diet and have added in many fairly high FODMAP foods. This week I even went a little crazy and had a bunch of garlic and mushrooms with several meals with no real effects, I was kind of surprised. I’m finally able to eat apples and stone fruit which are my favorites. I also ate a lot of raw food on my trip to the Deschutes with no issues so salads are back. I eat a TON of sweet potato these days which are pretty hard to handle for most SIBO sufferers but I eat several a day now.