Well if there is one thing that is for certain it is that the SIBO world in changing at rapid speed these days and Dr. Mark Pimentel of Cedars-Sinai dropped a few bombshells at the recent SIBO Symposium. I didn’t attend this year’s Symposium but I got a good summary from Shari so I’m just going to paste her notes here and then comment:
Just finished listening to Pimentel's Methane and Autoimmunity talk from the SIBO Symposium. Head is spinning!
*Food poisoning is NOT related to Methane
*Methane comes from environment and family. If you live in impoverished areas where calories are either hard to come by or hard to extract from low quality foods then methane is protective.
*Methane is not an overgrowth, it's a bloom and may NOT be SIBO (WHAT??)
*The older you get the more likely you are to have methane.
*Methane slows transit time.
*Methane makes you hyperglycemic, impacting both blood sugar and insulin (data for this).
*Methane predictive of obesity. Those who don't lose weight after weight loss surgery may have methane.
*Combination therapy (Rif/Neo) does not work well for methane, it often comes back quickly and you can't keep people of therapy two weeks out of every month.
*Methane is not an overgrowth, it's a bloom, outgrowing other bacteria. We don't know how much is in colon and how much is in small bowel. Methane is not dependent on lactulose so it doesn't always go up on the test. It may be mostly in the colon.
*F420 enzyme allows M. Smithii to take hydrogen and make methane, lovastatin blocks F420 enzyme. Methane production drops in days. Hydrogen bugs the get sick and die from the excess of hydrogen.
*Syn-10 (the lovastatin drug in trial) stays in gut and is not absorbed so none of the same lovastatin side effects. Red Yeast Rice is absorbed so likely not effective the same way.
*C-Diff causes post infectious IBS.
*You can get SIBO via FMT
*Fast helps, meal spacing necessary
*Methane + high fat diet may be recipe for weight gain as methane makes body more efficient with harvesting calories.
*If you have post infectious IBS, NEVER get food poisoning again. Always travel with Rifaximin and take 1/2 a pill with meals.
*Scleraderma only other autoimmune condition that seems to be linked to high levels of anti-vinculin antibodies.
*Allicin works temporarily for methane.
*Phase 3 research for Syn-10 starts in Sept
*Higher anti-vinculin ab predicts lack of response to treatment with Rif/Neo
*M. Smithii can use acid and ammonia to make methane so keep those lower in diet (ie lemon juice in water, ACV).
*In the process of investigating separate diet for SIBO and Methane.
*Norovirus can cause IBS even though it doesn't release Cdt-B, they are not sure why.
Let’s look at a few of these and how they seem to relate to my case at least.
Food Poisoning not related to Methane – I have definitely had food poisoning and had Cdt-B antibodies but no vinculin antibodies so my SIBO was not due to food poisoning which I had just figured it was until I had the IBSChek test. In my case the problem began with the Doxycycline which fits with the 3rd bullet point.
Methane is not an overgrowth, it is a bloom and may not be SIBO – This fits in my case and to me it seems similar to the way a c.diff infection happens. The Doxy probably killed off all my good bacteria and thus set the stage for a bad bacteria (technically an archaea) to take over and bloom as Pimentel calls it. Since being sick my m.smithii levels have been very high in stool tests, I wish I knew if it had been high beforehand or not.
Methane slows transit time – yep, thus the constipation
Methane makes you hyperglycemic, impacting both blood sugar and insulin – This explains why I suddenly was having high blood glucose levels after being sick. Makes me wonder what, if anything, can be done about it.
Methane predictive of obesity – well, not in my case. The methane made me lose weight like crazy and I still would be really thin if I didn’t work so hard at eating a lot.
Combination therapy (Rifaxamin/Neomycin) does not work well for methane – I wish I’d known this 3 years ago since maybe then my feet would not be numb all the time.
Allicin works temporarily for methane – yes, AlliMed is what finally took my numbers way down and in my case that temporary status has lasted several years. The bloom theory though makes me very leery of taking antibiotics again, I could see this relapsing completely if my gut bacteria get wiped out a second time.
I’m sure that Pimentel’s research will continue to unravel the methane issue, it seems to have the best hope for a real solution unlike the vinculin antibody form of SIBO which it sounds like just has to be controlled as best as possible. The new Syn-010 lovastatin drug is going into phase 3 trials and shows the most promising long-term drug for the problem but I really don’t want to be taking a statin unless I absolutely need to do it in the future. Until then, I just wake up grateful every day that I seem to have gotten through all of this as well as I did.