After finishing up three rounds of herbal antibiotics on September 8th I retested for SIBO on the 15th, waiting a week to get the herbs out of my system. This time I also did a 2 day prep diet to hopefully avoid the very odd results I had at the last test. Finally had some good news from a test – I made a serious dent in the bacterial levels going from a peak of 49 ppm methane (CH4) to a peak of only 10 ppm methane, that is an 80% reduction in levels. The other good news this week is that I weighed in at 155.4 on Wednesday, finally crawled up to my interim goal of 155. This is almost 8 lbs up from my low point in May. Now I’m aiming for 160. I really don’t know if I’ll ever get back up to 170 given the low carb diet I’m going to have to stay on but when I was in really good shape running I was at 165 so I’m ultimately shooting for that.
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.
Herbals round 3 – Done
Today I finish up my third round of herbal antibiotic treatment for SIBO. In June I started taking Berberine Complex and AlliMed after a bad relapse in May. This didn’t do much so I switched to a higher dose AlliMed and Neem protocol in July and did two 30-day rounds of it. The first 30 days I couldn’t handle the Neem too well and had to cut it in half but for the last 30 days I decided to just suck it up and deal with the discomfort that the Neem caused and ride it out sinec I was assured it would make a difference. Luckily the upset stopped after a week and I’ve actually felt petty good for much of the last month. I still have a few symptoms after dinner each day so I think the SIBO isn’t quite knocked out but is teetering a bit.
A Tale of Two Tests
It was the best of times, it was the worst of times. Nope, wrong tale but sort of fitting to my tale too. I got my latest test results back and do not know what to make of them at all, neither do the doctors, even though I’m feeling pretty good these days.
Just a reminder, here is my June 30th test, pretty much a standard looking SIBO test for a methane producer like me:
Now, here is my July 30th test after 10 more days on the Berberine/AlilMed protocol and 20 days on the AlliMed/Neem protocol:
New treatment plan
I had a meeting with Dr. Melanie Keller at the SIBO Center yesterday and then met with my doctor here today to go over a new treatment plan that I’m hoping will get those numbers back down. I evidently made the right move in changing over my herbal treatment a few days ago but Dr. Keller told me to double down on it so my new dosage is:
- 2 caps/3x day AlliMed
- 2 caps/3x day Neem Plus
SIBO: The Methane Strikes Back
I’ve about had it with this SIBO stuff. After my initial testing in January showed that I had SIBO my test in March showed that maybe I didn’t have it any longer but the jury was out in my mind. As of June 30th the SIBO is back and at about the same level as in January, this is not the summer sequel I was wishing for. I had been feeling quite a bit better so expected the numbers to be down instead of back up. I’m not symptom free and still unable to gain weight even with eating massive amount of fat so I expected to still have SIBO but at much lower levels than this test showed and figured I would need one more month of herbals to knock it down, now it is looking like multiple months still to come of treatment.
A different kind of cocktail hour
A few months ago my SIBO induced malabsorption issues were starting to cause vitamin deficiencies that were severe enough that I was getting symptoms. I did some B12 injections but that wasn’t making a difference so my ND suggested I go in for a Meyer’s Cocktail. I’d never heard of this before so did some searching on the internet. Definitely not a mix of vodka and Meyer’s lemons, instead it is an IV injection of a mixture of vitamins and minerals, in my case heavy on the Bs, C, Magnesium and some other good stuff.
Fat tea is so freaking good
Matcha/Ginger Butter Tea
In an attempt to stop the SIBO caused weight loss I’ve been experiencing I had to add more fat to my diet since I can’t really add in carbs that give me extra calories and one can only eat so much protein per day. I was adding ghee to all the vegetables I was eating plus cooking with it and coconut oil but it still wasn’t doing the trick. Enter my new secret weapon that I hope is going to work – the centuries old butter tea.
This is not quite the traditional Tibetan Yak Butter tea but is kind of close. The recipe started out as Bulletproof Coffee and I was introduced to it by a friend last week. I’ve been off coffee now for 5 months (I know it is a crime) and wasn’t ready to go back so I decided to just try it with the ginger tea I’ve been doing lately. A few days ago I added some green tea to the mix and this morning made it with matcha, pretty amazing. I now don’t think I’ll ever be able to drink plain old tea again, it will just taste like flavored water. Plus, I get about 165-200 calories of good quality fat per cup of tea. I drink about 3 of these a day (minus the actual tea later in the day) which gives me an extra 500-600 calories per day without having to try and eat any more food in. So far I’ve only had one weigh in but got back above 150 so I’m hoping it is doing the trick for me.
Here’s the recipe:
1/4-1/3 c. ginger concentrate, made by blending ginger & some bit of water into juice 1-1.5 t. matcha tea powder 1 T. coconut oil 1-2 t. ghee or butter (I use Ancient Organics grass fed ghee) Boiling water
Put the ginger in a measuring cup, add in matcha, coconut oil and ghee. Pour boiling water over top. Mix in a blender or with an immersion blender which is what I use. Strain into a mug to get rid of the ginger fiber and enjoy.
Six months into the SIBO adventure
SIBO comic book by Dr. Sandberg-Lewis from the SIBO Center. The guy also plays a mean guitar singing about the digestive system.
It has been a little over six months since my gut totally exploded after Christmas and started this whole adventure into the world of SIBO. I guess it has really been about 9 months but the first three months or so were manageable, it didn’t become really nasty until the end of December when I went back to my normal rice & bean diet after the candida cleanse we did when I thought this was only candida. It has been six months of ups and downs and still trying to unravel this mess in my gut.
After taking Doxycycline last fall and having gastric distress I went through a whole month of hell and rapid weight loss in January trying to figure out what exactly was wrong with me. When I found I didn’t have cancer but instead something called SIBO I was pretty happy, SIBO seemed like something that could be cleared up in a few weeks. Boy was I wrong. At least with colon cancer you can cut something out if caught early enough, with SIBO you just somehow have to sterilize your small intestine while not destroying your large intestine in the process and then fix any underlying motility issues that allow the bacteria to migrate upstream in the first place. It is a bitch to get rid of as I’ve since found out and while it is there complications abound.
Hypnotherapy and Herbal Antibiotics
I finally started coming out of my relapse last Saturday and have felt fairly decent since Monday morning. My gut has remained pretty calm most of the time, even after dinner with just a small level of symptoms. My feet are still numb and bothering me some but I’ll see the neurologist next Friday to start looking into that issue. Also doing another vitamin cocktail push into my veins that day. I have an endoscopy scheduled for Monday the 23rd though the bad pressure in my upper GI has let up a lot since my SIBO symptoms have been clearing out.
Dealing with the three month relapse
During my early May appointment my doctor asked if I’d had a flare-up of symptoms recently. At the time I was doing pretty well and had been in the longest streak of good days I’d had since the SIBO got really bad in December. She warned of a typical two to three month flare-up that is experienced by a lot of people on SCD. I finally went back and re-read Chapter 9 of Breaking the Vicious Cycle and found this little paragraph I’d obviously just overlooked the first time through:
Most cases begin to improve within three weeks after the dietary regime has been started and improvement usually continues. At about the second or third month, there is sometimes a relapse even when the diet has been carefully followed. This can occur if the person develops a respiratory infection or for no reason at all. Do not allow this to discourage you! Once the individual gets over this, improvement is usually steady with minor setbacks occurring occasionally during the first year.