There is no denying that antibiotics are one of the most beneficial medical innovations of modern history. They have helped eradicate many communicable diseases and saved countless lives. But antibiotics have also brought with them a number of unforeseen problems and health risks. Before we go any further, I want to say that I’m not anti-doctor nor against traditional medicine, but each has its time and a place. Antibiotics are overprescribed and shouldn’t be our default choice for treating everything. For numerous reasons, many people are turning to herbal alternatives to antibiotics for treating SIBO. This article is part of a series about treating SIBO. If you missed the last parts of the series, catch up here:
- Part 1: What is SIBO?
- Part 2: Symptoms of SIBO
- Part 3: Causes of SIBO
- Part 4: Diagnosing SIBO
- Part 5: Breath Tests for SIBO
- Part 6: Hydrogen vs. Methane SIBO
- Part 7: Antibiotics for SIBO
What is an Antibiotic?
According to MedicineNet.com, an antibiotic is:
A drug used to treat bacterial infections. Originally, an antibiotic was a substance produced by one microorganism that selectively inhibits the growth of another. Synthetic antibiotics, usually chemically related to natural antibiotics, have since been produced that accomplish comparable tasks.
As humans, we have been using natural antibiotics for centuries, even before we knew what bacteria was. For example, garlic has been used since at least 2600BC for its healing properties. Today, we now know that garlic has natural antibacterial properties.
Why Choose Herbal Alternatives to Antibiotics for Treating SIBO?
There are already several pharmaceutical antibiotics which are commonly prescribed for SIBO (such as Rifaximin). So why would you choose herbal antibiotic alternatives over these? There are three main reasons:
- Antibiotic resistance
- Fewer potential side effects
- Herbal antibiotics may be more effective
1) Herbs Don’t Cause Antibiotic Resistance
In 1929, Alexander Fleming discovered penicillin and changed modern medicine completely. Doctors were convinced that antibiotics would cure all bacterial diseases. In 1963, the Australian physician and Nobel Prize winner Sir Macfarlane Burnet even said that by the end of the 20th century humanity would see the “virtual elimination of infectious disease as a significant factor in societal life.” In 1970, the Surgeon General William Stewart said that antibiotics would soon “close the book on infectious diseases.”
They couldn’t have been more wrong!
What they didn’t realize was that bacteria are capable of adapting to antibiotics and becoming resistant to them. This is a VERY serious problem, and one which shouldn’t be taken lightly. Thanks to antibiotic resistance, diseases which were once treatable — such as tuberculosis — are often now fatal. We may soon see the reemergence of diseases like typhoid, diphtheria, and many others.1
Keep in mind that antibiotics are often ineffective in treating SIBO. Even when the first round of antibiotics works, the SIBO often comes back after just a short time. As researchers point out in an article in Gastroenterology2, SIBO patients often require multiple rounds or continuous courses of antibiotic therapy. To prevent resistance, they recommend rotating antibiotic regimens to prevent resistance.
Herbal alternatives to antibiotics work on multiple levels in the body, so resistance is less likely to occur. Further, by using herbal remedies instead of turning to pharmaceuticals every time you get sick, you slow the spread of antibiotic resistance.3, 4
2) Fewer Side effects with Herbal Antibiotic Alternatives for SIBO
There are three main drugs which are used for treating SIBO: Rifaximin, Neomycin, and Metronidazole. Each of these has some pretty nasty potential side effects. I’ve listed some of them below — but bear in mind that these are just some of the potential side effects!
(Source: Drugs.com)
As if dealing with SIBO symptoms isn’t bad enough, you’ve also got to worry about antibiotic side effects! With herbal antibiotic alternativess, there is still a risk of side effects. However, the side effects generally aren’t going to be as severe as with prescription antibiotics.3 One point worth mentioning is that even herbal antibiotics can kill off good bacteria. So, even you use herbal treatments instead of prescription antibiotics, you still must make diet and lifestyle changes to help restore gut dysbiosis.
3) Herbal Alternatives to Antibiotics Can Be Very Effective
Need another reason to choose herbal remedies over antibiotics for SIBO? How about the fact that herbs may be more effective in treating SIBO than prescription antibiotics! Now, bear in mind that there have been really few studies on pharmaceutical antibiotics for SIBO. There have been even fewer for herbal treatments for SIBO. In fact, there are only two (yes, TWO!) studies to date which look at how herbal alternatives can treat SIBO. And one of these studies was on just one person!5
However, the lack of research doesn’t mean that herbal alternatives to antibiotics aren’t a good solution. In the larger study, which was published in the journal Global Advances in Health and Medicine6, the results are pretty impressive. They took 104 people who had been diagnosed with SIBO through lactulose breath testing. Of these, 37 of the patients were treated with herbal alternatives to antibiotics and the remaining were given Rifaximin.
The results?
46% of the patients who took herbal alternatives to antibiotics had a negative breath test upon follow-up, compared to just 34% of the Rifaximin users. The researchers concluded that herbal therapies are “at least as effective as Rifaximin for resolution of SIBO.”
Doctor Siebecker, who is a leading expert on treating SIBO, says that she and her associates have regularly used herbal treatments for SIBO since 2011 and “have consistently found them to be as effective as pharmaceutical antibiotics in relieving symptoms and reducing gas levels on breath testing.”5
What Makes Herbal Alternatives to Antibiotics So Effective?
Why would a natural substance be more effective than the prescription drugs which scientists worked for years to develop? The book Herbal Antibiotics by Stephan Harrod Buhner describes it well. He talks about how pharmaceutical antibiotics are isolated chemicals – meaning they are one chemical. Because they are only one thing, it is easier for bacteria to adapt to them and develop a resistance. By contrast, herbs are made up of many compounds. For example, garlic (which is one of the best known natural antibiotics) contains dozens of compounds.
All of these compounds work together and can attack bacteria on multiple levels. It is much harder for bacteria to adapt to herbal treatments because of how complex the herbs’ structures are.7 Even the individual compounds in herbs can work in complex ways. Allicin, which is one of the main antibacterial compounds found in garlic, is a particularly good example of the complexity of herbal treatments.
Interestingly, allicin isn’t present in undamaged garlic. But, when the garlic becomes damaged, a chemical reaction occurs and allicin is produced to protect the plant from disease and other damage (that is why garlic becomes pungent once you cut it open). Once in the body, allicin undergoes a redox-reaction with proteins, which is thought to be the source of its biological activity.8 *Allimed does not contain the FODMAPs part of garlic (learn about FODMAPs here), so it is okay to take for SIBO.
Here is some food for thought. Animals can move, and this allows them to come up with evolutionary survival mechanisms like being able to run fast or have sharp claws to fight predators. Plants don’t have the ability to move, so they’ve had to come up with other ways of protecting themselves. They’ve evolved chemical structures to protect themselves – like how poison ivy will make you itch or kale tastes bitter so animals won’t want to eat it. These mechanisms have been perfected in millions of years of evolution (definitely longer than we’ve been creating chemicals in labs!).
With a bit of research, we could utilize these natural plant compounds for our own benefit. Consider the fact that about 40% of all prescription medicines are plant-derived. About 25% of these come from the rainforest, and we’ve only tested fewer than 1% of all the tropical trees and plants in the rainforest! 10
The bottom line? Plants are pretty amazing and their healing powers shouldn’t be underestimated.
Which Herbal Antibiotic Alternatives Can Treat SIBO?
Unfortunately, there hasn’t been much research into herbal alternatives to antibiotics, and even less research about herbal treatments specifically for SIBO (it seems that drug companies would rather fund research for expensive chemical pharmaceuticals than cheap, natural remedies!).
Disclaimer: Remember, none of these herbal treatments have been approved by the FDA for SIBO. While there is some evidence that these substances may have medicinal benefits against infections, it does not necessarily mean that they will work for you. Always talk to your doctor before taking any supplements for treating SIBO.
Here is the herbal regimen I used for treating SIBO:
- Allimed (Allicin) 450mg: Allicin is a component of garlic. Take 1-2 caps 3x per day for a total of 14 days (start with 1 cap 3x per day and on day 3 increase to 2 caps 3x per day). It is important that you take 450mg! You can buy Allimed here. You will need 2 packages for a 30-day course.
- Berberine Complex: Berberine is a compound found in Oregon grape, barberry, goldenseal, and other herbs. Take 2-3 caps 3x per day for a total of 14 days (start with 2 caps 3x per day and on day 3 increase to 3 caps 3x per day; can cause headaches). You can buy Berberine here. You will need to buy 2 bottles for a 14 day course.
- Neem Plus: Neem is a tropical evergreen tree. Take 1 cap 3x per day for a total of 14 days. You can buy Neem here. You will need 1 bottle for a 14 day course.
I took all 3 of these herbal antibiotic alternatives for a 14 day course. Many people take herbal remedies for SIBO even longer though — such as 1 month courses! I took these herbal treatments while I was doing the elemental diet (which I wrote about here). You don’t have to do elemental though. In fact, many people do either/or.
I also took:
- Interfase plus (Klaire Labs): This is a biofilm disruptor. It is unclear how much it actually helps, but it certainly doesn’t hurt and I was at the “let’s toss the kitchen sink at this”approach. Take 2 caps 3x per day. If doing elemental, take away from the elemental formula as much as possible. You can buy Interfase Plus here. You will need 1 bottle for a 14 day course.
- MotilPro (Pure Encapsulations): This one is for the long term. It’s a prokinetic. It’s mostly ginger and does cause a bit of burning so some dislike it but I’ve found it effective. Take with lots of water to minimize that burning in the esophagus sensation. Take 3 caps before bed and 3 caps 1-2 times a day between meals. You can buy MotilPro here. Go ahead and buy 2 bottles, 1 for the herbal antibiotics course and another bottle for post-treatment.
***While I totally understand why someone would choose herbal remedies over prescription antibiotics, it is important to note that herbal treatment courses are often much longer. It is like using a handgun instead of a grenade. 😉 And, again, I emphasize that these are supplements and are not approved drugs by the FDA. Your doctor might not recommend them for that reason.
Important Notes about Herbal Antibiotic Alternatives for SIBO
Whether you are taking herbal remedy or pharmaceutical antibiotics for SIBO, you should wait 14 days after finishing a round before retesting. This is critical for the accuracy of test! However, don’t wait more than 16 days to retest; you want to retest before regrowth of bacteria (recurrence) has time to occur. After finishing with herbal or pharmaceutical antibiotics, you will want to take a prokinetic agent (I took MotilPro during the herbal antibiotic alternatives course and added 2 more prokinetics post-treatment). You can start with the prokinetic immediately after antibiotics, even before you’ve retested.
I took:
- MotilPro: Take 3 caps before bed and 3 caps 1-2 times a day between meals.
- Iberogast: Take 20 drops before bed
- Erythromycin- 50mg: This is actually an antibiotic but a really low dose it’s shown to be highly effective as a prokinetic to stimulate the MMC. You’ll need a prescription for it. It comes in 250 mg dose and I cut in 4 so end up with like 67 mg or so which is fine. Take before bed.
Remember, herbal alternatives may be a better than pharmaceutical antibiotics – but even these aren’t the sole solution to treating SIBO. To get rid of SIBO and keep it away, you’ve got to treat the underlying issues which caused the bacterial overgrowth in the first place. That means making changes to your diet and life. We will talk about these changes in the upcoming articles in this series.
Ready to eliminate SIBO once and for all? Get your copy of The SIBO Solution: Your Comprehensive Guide to Eliminating Small Intestinal Bacterial Overgrowth by clicking HERE. You’ll also receive a BONUS SIBO Detox Support Guide mini ebook with your purchase.
Latest posts by Sylvie McCracken (see all)
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- Treating H. Pylori (Part 2): How H. Pylori is Contracted - August 3, 2022
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Hello Sylvie, I’ve been taking a combo of Atrantil, Oregano oil capsules and Allimed for 5 weeks. My symptoms have improved about 80% but they return after 48 hours when I stop taking the supplements.
I want to give the elemental diet a go.
I want to do a breath test before I start that.
Do you know if I would get an accurate reading if I’m taking these supplements and I’m feeling 80% better? Or should I stop taking them for a few days in order to get a clear result?
Best Regards,
HI Sylvie,
I was wondering about the herbal antibiotics, did you take them seperately after eachother or did you take them all at the same time.
because I could not determine that from your story.
I wonder if anyone else has had weird effects from Berberine like sweating? I used Candibactin BR as mentioned in the SIBO study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/
I couldn’t do Berberine at ALL, symptoms similar to yours, but then, I have to be careful with all herbals, likely because I have a severe CYT450 liver-enzyme problem, NOT helped by decades of S.I.B.O. putting unnecessary stress on my liver. I did well on Neem. I did fine on Rifaximin. I’d also suggest you make sure you’re not having trouble with gluten cross reactors. I don’t have celiac–so gastroenterologists gave me a lot of horrible advice, telling me I was fine on wheat–when I lack the gene to handle gliaden, another protein in many grains. But, if your gut is swiss cheese from S.I.B.O. check the list for cross reactors carefully–include SUGAR, the worst–and make sure you’re not also having problems at that level. Let me comment that it’s a sad testament to modern medicine that I for years described CLASSIC and PROFOUND symptoms of S.I.B.O., related to doctors that I’d had a childhood of nearly non-stop antibiotics and NOT ONE doctor or clinic–including two national-class clinics–checked for S.I.B.O. I suspect it’s an epidemic and why a lot of people are very sick, but getting no help!
Hi Slyvie,
In March 2018, after finishing a purchased breakfast sandwich, I immediately started to cramp up and feel a burning sensation below my ribcage middle section. 2 weeks prior ate at several questionable establishments while out west visiting friends. Went to see GI. Endosocopy and Colonoscopy were fine except for mild case of gastritis. Symptoms persisted for weeks. Went back to GI. Performed CAT Scans with and w/out contrast and ultrasound, all negative. Went back to GI, Told in August 2018 that I had SIBO, but did not found out it was methane dominant until visiting another GI in January 2019. Both diagnosis confirmed by breath tests. Neither GI shared the actual numbers, which I am going to request. During this time, I have not experience diarrhea or constipation. I have normal and regular bowel movements. How can this be? After two unsuccessful rounds of Xifaxin 14 days each, I opted for herbal antibiotics 14 pills for 30 days. First three weeks felt no symptoms after breakfast and lunch but felt them after dinner (bloating, gas, cramping) However, the last three days no symptoms after any meal. But my gut feels abused/raw from the strong herbals. In the meantime, awaiting results of comprehensive stool test. Supposed to start LOW FODMAP diet, min. 2 weeks next week. Based on your advice and reading Dr. Pimental approach I will take prokinetics after treatment. I read that food poisoning can also cause SIBO. Could food poisoning affect motility? Is it possible that once I get this bad bacteria out that was possibly caused by food poisoning that my gut flora will become rebalanced? Thank you advance for your advice.
Theo
Hi Sylvie, great information. I was diagnosed SIBO-D with a high hydrogen level. I began by unsuccessfully treating with a month of Rifaximin. I do not have my gallbladder, and read about a lack of bile acid affecting the Rifaximin working. Anyway, I then went through months and months of different herbal combinations. I have a genetic issue with sulfur, and the Allimed bothers me tremendously. I currently am taking 3-4 HCL per meal, ox bile, , Interfase Plus, Turmeric, L Glutamine, K2 and D3, Berberine as you suggest. I have found Oregano Oil alone works, but I have to spread 500 mg a day into 3 doses. However, after using for three months with a month in between each It’s no longer working. It’s so frustrating to treat constantly only to have it return. I have noticed a strong correlation with cycles. I feel ok most of the month, but by day 24 in my cycle, I get the gurgling, cramps, diarrhea, belching, and right sided abdominal pain( which I not so fondly call my alien invasion)This is usually when I re-treat for two weeks. The issue is, I feel like I’m always re-treating. If I take less HCL my symptoms also creep back. I do very strict SCD. I also have constant muscle aches and pains, high PTH that doctors won’t treat because my calcium is always just under high range, even after finding calcifications in my arteries. I’m 39, always been healthy, cholesterol 125 total 75 HDL weigh 110 lbs at 66 inches. The calcifications are new since SIBO diagnosis. I also broke two ribs from dancing?? I can’t help but feel like this is caused by bacteria with calcium biofilm shells. Interfase has helped relieve chest pain and shortness of breath. Have you ever heard of SIBO triggering a heart problem? I have seen over 45 different doctors, and am going in circles. Five ‘re-tests still show positive Hydrogen with little change. Any thoughts on my current treatment plan, as I cannot tolerate the Allimed? Thanks so much(sorry for long rant). Family thinks I’m anorexic and crazy, so it’s nice to vent in a safe zone.
Hi mellisa
I am in same boat I donno whom to reach I need help with my diet who was ur dietician doc
You HAVE to get your parathyroid treated!!! It can cause heart problems on its own andd bone problems.
Hi Sylvie
Is the Iberogast and MotilPro to be taken after the herbal treatment or also during the treatment? I just wonder if it could help me avoiding constant diarrhea.
Thank you!
Nicci
Hi sylvie! I’m not sure if you still log in here but while reading carefully your experience and what herbal supplements you tried… (which I will definitely be trying as well) could you specify if you took the 3 of them for 14 days combined? Or 14 days of one, then another 14 days of the next and so forth? My guess is I gotta combine everything to make it stronger. Just wanted to double check with you. Thanks for your help and recommendations
From reading this, it seems to be all at the same time. I am trying this now and it’s definitely NOT working. If anything my symptoms seem worse! I’m not following an elemental diet, however, I have eliminated a great deal of sugar. I am on day 7 or so, so maybe I just need to wait it out which I will, but all the products were over $200, so such a bummer if it doesn’t work.
Did you test before the protocol Brian? Would be great to see your test afterwards too.
HI Sylvie,
Could you recommend a substitute for jo mar amino acids please, it’s no longer available on amazon and I can’t get it shipped to the uk. I would like to do homemade elemental and am unsure which is the equivalent from the vast choice on offer.
Many thanks
Helen
Hello,
I’m sorry but I didn’t understand how should I take natural antibiotics. Do I have to take all of them three time per day for 14 days ? Should I alternate them ? Can you please be more precise ?
Thank you
Hi Sylvie, thanks for all the information. I live in Dubai and can’t seem to find motilpro on any website that delivers to my location. Moreover, it’s out of stock from most places like amazon. Could you suggest an alternative?
Hi Fouad, You can try one of the other prokinetics I list on this resource page: https://hollywoodhomestead.com/sibo-ebook-resources/
Thanks!
Hi,
I have been on the Allimed, Neem, and Berberine for 10 days now. Initially I thought it was working because my back pain has been improving. But my bloating has been CONSTANT while on these meds, and seems to be actually worse than before I started the herbal course. I know there can be bloating with “die-off” but my understanding is that resolves within a few days. What was your experience with bloating while on these meds? It’s just really hard to know if they’re helping or making things worse. Any additional info about your experience is greatly appreciated!
Leigh,
I am currently on day 13 of allimed and berberine, which I will be taking for a month. However, I have noticed the same thing. bloating never stops. I wake up with some bloat present and the second I eat anything I am a balloon all day. It is discouraging and I am not sure if this is normal or now. How did things turn out for you?
We are on the same boat. My bloating is just as you described. Never goes away and worse with herbals that i am still on. I am hoping i will go back to my old bloated self which was relatively better after i stop the herbals. Sylvie, did you have the same issue?
Hi Sylvie-
Thank you so much for sharing all of this info. I was just diagnosed with SIBO and have opted for the Herbal treatment. I have ordered all of the supplements you have suggested, however, I was wondering if you could share a schedule/combo that is most effective.
Thank you in advance!
Kristina
Hi Sylvie:
Thanks for this information and details of the elemental diet and herbal protocol. I have been diagnosed with hydrogen & methane SIBO. Both about equal in terms of the breath test measure. With the guidance of a medical practitioner I’ve done 150 days of herbal antibiotics to no avail.
I’ve reviewed your protocol with her and she supports me in my plan to try it.
My question is did you take the herbals while you drank your Elemental Diet smoothies or in between?
Thanks!
Mitch
Hi .thanks for your good information. I just want to ask about my condition because I got low stomach acid , if I take that herb can I take Appel vinegar just brack down the food because without that I can’t eating just because of reflux . Please reply me soon as possible. Thanks
Afshin
Hello! I have a very stubborn SIBO case (no response to the antibiotics, no response to the elemental diet so far – 2 weeks in). Will begin the herbals this week. I am very surprised by the dose of Allimed you recommend : SIBO centers recommend 1cap, 2xday whereas you recommend 2caps, 3xday. I am willing to go as far as I can, but am kind of worried about such a high dose. Any thoughts on that? Thank you very much for your work, it helped me figure out what my next step will be. Cheers 🙂
Hi so I have been taking atrantil for about a month and added Now super enzymes when I eat and the herbal protocal you outlined above: allicin, berberine, neem plus, about 3 weeks into taking the atrantil. I have to say the atrantil did help provide relief for the bloating and gas. But I think I got the best relief from constipation when I started taking the digestive enzymes and then the herbal protocol (couple days after I started enzymes) so I am about a week into the herbal protocol now. Has anyone experienced rosacea type symptoms on face along with dryness and flakiness if skin on finger tips and hands especially on thumbs? I also find sinve I have been taking the herbal stuff I am urinating like crazy!!! So I don’t know if my dry skin is related to being very dehydrated because I am urinating all my water out or if it’s relates to liver processing all the garlic and berberine.. any help appreciated
Hi Sylvie! Thank you for your extremely informative and helpful posts, as well as The SIBO Solution which I’ve purchased and read in its entirety. I too was diagnosed with a pretty severe case of methane SIBO and am currently finishing up a round of antibiotic treatment with Xifaxan + Metronidazole. Although I feel *slightly* better I don’t think I’m yet cured, by any stretch of the imagination.
I finish the antibiotics Tuesday and retesting next Friday to see how much of an impact they had. I also plan on starting the SIBO diet and prokinetics Tuesday, and just want to confirm – did you take Erithromycin, MotilPro and Iberogast concurrently? Or did you choose just one? If you could let me know your experience, that would be very much appreciated.
Thank you again! 🙂
– Gabrielle
Hi Sylvie,
I am a 21 year old male with hydrogen SIBO, as confirmed by lactulose breath testing. This all started in November, when I went carbohydrate-free (rice, potatoes, pasta, etc.) for 3 weeks. I become very constipated during this time, and re-introduced carbohydrates back into my diet. I then developed a dull pain in the lower right part of my abdomen that lasted for about 2 weeks, as well as nausea and bloating and gas in the form of excessive flatulence and burping. I have been on a ten day course of Metranidazole and Levofloxacin, followed by a ten day course of Rifaximin. None of these antibiotics offered any relief. I have been managing my constipation with water and fibre supplementation, but still strain occasionally on the toilet and have blood when I wipe. Stool testing showed a lack of lactobacillus and enteroccocus strains, as well as the presence of hemolytic E. coli and Group B beta Strep. The stool testing also showed abnormally high levels of red blood cells and secretory IgA. Previous probiotics that I have tried did not contain enteroccocus strains; I therefore have ordered a probiotic containing both lactobacillus and enteroccocus. I have also ordered Allimed.
What do you advice? I am desperate. Any help would be greatly appreciated.
Thank you,
Alex
Hi Alex,
I’m sorry to hear it’s been so tough. You’ve got a lot going on and REALLY need a doctor to guide you with this.
One thing I would caution you about in the meantime is the fiber supplements. I wouldn’t be surprised if those are doing more harm than good but again you’ll have to work with your doc to see what alternative to that you can take given ALL the things you’re dealing with.
Hoping you find relief soon,
Sylvie
Hi Sylvie, I want to thank you so much for your site, which helped me quickly get up to speed on SIBO after I was diagnosed in October when my breath test came up positive for SIBO methane (the constipation variety of SIBO). I wanted to return and let you and others here know that the new herbal medicine Atrantil worked for me. I just saw my gastro this week and got the all clear. I didn’t go low carb, because like some other commenters, I had read Dr. Pimentel’s advice about happy bacteria being easier to eradicate. I did optimize my nutrition, following The Perfect Health Diet (Paul Jaminet) recommendations on nutrition and supplements. It’s not a difficult diet and I plan to stay on it for life. I’m crossing my fingers that my SIBO is gone for good.
I’m so happy to hear that, Sally! And I really appreciate you coming back to share what worked for you so others can benefit.
Would love to hear from you when you retest. I’ll be crossing my fingers for you!
Sylvie
Hi
I have been having sibo for 3 months now and my Gi Doctor gave me a sample of Xifaxan for 9 days 550mg twice a day for 9 days .the reason 9 days because that is all he had and my insurance did not cover it because it is costy so i took Xifaxan for 9 days and started getting better for 5 days and the doctor prescribed Flagyl 3 times a day to be taken after finishing Xifaxan and now i started getting the bloating again and the flagyl seems to be not working at all.i’m so confused and in pain this sibo is really painful.i’m on low carb diet not and still not feeling good.any advice please?
My advice would be to retest. I’m guessing that course wasn’t enough to treat your SIBO but die off is also pretty uncomfortable. Without a test it’s hard to know…
Hey, do you think it would be overload to use Allimax, Biocidin Advanced Formula (look it up to see the ingredients), and Candibactin AR + BR to remove a reallly tough case of SIBO?
Plus MoltilPro and Interfase and peppermint oil in between meals.
I just wanted your opinion,
Thank you!
I can tell you that the Allimed alone was quite tough on my gut, especially when I was doing it in combination with elemental. I have no idea how that combo you suggested would work. Why not do Allimed + Berberine + Neem (in addition to Motilpro and Interfase as you mentioned)?
Hi Sylvie- Did you find doing the elemental diet was hard on your system? Did it take a long time for your digestion to return to normal after the 14 days of the elemental diet? I’m considering the elemental diet as Allimed seems to be pretty strong for my system. I may need to just start very small and work up with the Allicin. Thanks for all your help, info and posts!
What happens if you have SIBO symptoms but get worse after taking dextrose? Is it possible to have SIBO AND Candida?
Hi Chris, You might need to experiment with a different carbohydrate. Yes it is possible to have SIBO and candida simultaneously but your doc would have to test you to be sure.
Thank you for all the great information! In regards to taking the herbal antibiotics, I’ve read mixed reviews on implementing the restricted diet during the course of antibiotics. Dr. Pimentel discusses this topic in an interview with Chris Kresser. Here is a direct quote from that interview:
“I have told my patients from day one of rifaximin or treating with antibiotics — and this goes back to the 1980s; this is an old microbiological concept — happy bacteria, happy and well-fed bacteria, are more sensitive to antibiotics and are easier to kill. What that means is that most antibiotics work on the replicating cell wall of bacteria. When bacteria are in hibernation, starving, distressed, they wall off, don’t replicate, and they just sit there, waiting for conditions to improve. That’s a survival mode. So when the bacteria are in survival mode, antibiotics won’t penetrate and won’t work as well (…) If you give guar gum or you augment their eating — so now you’re feeding them, they’re thrilled, they’re enjoying all that food — they’ll be more sensitive to rifaximin. So when I treat with rifaximin, or antibiotics, in general, for these IBS patients, I don’t want them to be on a low-FODMAP diet simultaneously or any kind of carbohydrate restrictions. I want those bacteria happy and fed because they’ll respond better, in my experience, and the guar gum study kind of supports that notion.”
So my question is, should you do the herbal antibiotics first, with no restricted diet and then follow with the restricted diet, or do both simultaneously? Thanks!
There’s definitely two schools of thought on that. The truth is I can’t definitively say… It’ll be interesting to see more studies on this (hopefully not too many years from now).
Thank you Sylvie for creating this very informative and helpful series on SIBO. I’m currently on day 11 of this herbal antibiotic protocol in conjunction with the Fast Track diet recommendations by Norm Robillard. My abdominal bloating with D is brutal right now – similar to when my SIBO symptoms are at their worst! Just wondering how long after you finished your protocol did you get some relief from the abdominal bloating? Guess I’m just looking for that light at the end of the tunnel:)
*FYI, I always get relief from SIBO symptoms when I follow the FT diet strictly so I’m attributing my current symptoms to the herbs.
Hang in there, Robin. It may be die off symptoms… I can’t remember *exactly* when I felt better but I remember distinctly that: A) it was gradual slow progress (even when my test was negative I wasn’t feeling amazing) and I felt pretty awful during treatment no matter which protocol I was following. Glad the series has been helpful. The herbal antibiotics were definitely hard on my gut as well but I just pushed through it. Hope that helps! -Sylvie
I had a positive breath test for methane dominant SIBO. I took a 14-day course of rifaximin and neomycin and switched from low fodmap to high fodmap during that time period (based on Chris Kresser and Dr. Pimental’s advice to do so during antibiotic treatment). I started MotilPro at that time and continued with my usual magnesium to keep things moving. The bloating was just as bad on day 14 so I continued with GI-Synergy after the antibiotics and switched to SCD/low fodmap/paleo. The GI Synergy blend contains some of the same ingredients that you recommend but not all. I am 5 weeks into a 6 week course and the bloating has not gone away. I am curious if anyone has bothered with retesting when bloating is still very apparent.
Thanks for this wonderful series! I have SIBO (test results peaking at 80+ for M and 25+ for H) and I have done a course of antibiotics followed by a month of herbal antibiotics (allicin, neem & oregano oil). I felt better during the herbal protocol and afterwards for a while, but now a month later I feel I’ve had some relapse. Would it be helpful to try a new round of herbal antibiotics? I have extras here, I just can’t seem to find any information online about taking multiple courses. Thanks!
You’re welcome! Glad it was helpful, CG. Hope you kick your SIBO to the curb soon. – Sylvie
Thanks for this. I’ve recently gone back to my traditional ethnic foods which include garlic and lots of it. Also parsley which has benefits of its own, but modern people will care most that it nullifies the “garlic smell” you get if you eat lots of garlic. I noticed right away that my CFS was gone, totally gone after a couple of hours. Read the oregon university (edu) site to find out how to cook it properly (that is, don’t cook it and why). Once I was eating it when prepared right, it was the answer to sibo, other gut issues, fatigue, even insomnia. I had this constant vague alarm feeling I couldn’t ever get rid of, not drugs, not anything. It was exhausting and came with a low grade fever constantly. Garlic is amazing stuff if you don’t mess it up in cooking. I suspected others discovered this too. They did. This article is proof.
Hi Sylvie,
I have sibo and after a previous bad experience with pharma antibiotics for an unrelated condition I was so happy on finding your site with your recommended natural protocol.
I initially did 3 weeks elemental followed by one months natural antibiotic and have gone from high hydrogen and methane sibo to just methane sibo and was about to do a second course of elemental with the herbal antibiotics this time when I saw an article on the harmful effects of berberine, specifically that it inhibits DDP-4 in the body- this is the mechanism in the immune system used to kill cancerous cells.
Naturally this is alarming and I wanted to know your thoughts on this? and if it would be safer to use pharma antibiotics after all .
Many thanks
Helen J
Such great information – thank you for sharing! You mentioned that you took MotilPro while doing the herbal protocol. Can one take a prokinetic during a course of pharmaceutical antibiotics as well, or is it best to wait until the course is complete? Thanks!
I really appreciate all your information! I have a 17 year old who is very sick with SIBO. You have laid out such a perfect plan that I am wondering what your book offers as far as more information? Thank you, this really shows how much you care about people suffering from SIBO. You are an amazing person.
Hi Sylvie. Is there more information in the purchased copy than what we can read here? But more importantly, once youve stopped the kill phase WHEN you say retest within days because the bacteria can start to repopulate again, What SHOULD you be doing once you immediately stop the kill phase in that days? How do you prevent it repopulating so soon after you finish treatment? Thanks
Hi Sylvie,
Thanks so much for the great info and your book. I started the herbal antibiotics protocol – berberine, allicin and neem, I will start the interfase tomorrow. I am curious though, I still haven’t had any die-off symptoms, and I am on day 12. Just general lack of energy, but not all the time, but that is probably because I am eating only chicken soups with carrots, some organ meats, rarely eggs and aged cheese. I have had IBS (alternating C and D, but mostly D) my whole life, so I know it’s SIBO. Two years ago I tried the Candida diet, because I also have yeast, so I know how herbs work and I am very well familiar of the herx reactions. But since I started this SIBO protocol- nothing. I was wondering if that’s waiting around the corner, or is it possible those herbs are working their magic without die-off? I am taking them on an empty stomach. Other than that I feel very good, no D, no bloating.. but that’s also probably because of the mostly meat-oriented diet, and no carbs and sugar (although I started the protocol with a two day master cleanse- maple syrup and lemon water with cayenne, to cleanse my system).
I’d love to hear your thoughts.
Thanks!
Did you not get tested before starting the protocol? I would get tested. I’d be very curious to hear your results.
Hi Sylvie,
I haven’t done a breath test, first of all because where I live nobody’s heard of SIBO, so nobody does this test. But as I said I have had IBS my whole life, and have pretty much all the symptoms associated with SIBO. After years of research I found this one fits completely. Probably hydrogen predominant because of the D. Also, I have done other tests that have showed I have overgrowth of bacteria in the intestinal tract, like candida, e-coli, types of staph and strep, and a few others. So that is why I was wondering if the herbals are still working, even though there is no die-off reaction? Or perhaps this time my body is getting rid of the toxins more efficiently (because of cleanses, etc), so there’s no overload of toxins to make me sick..
I’m about to do the SIBO breath re-test after the herbal treatment. I’m taking some prokinetics and I’m wondering if have to stop the prokinetics before the SIBO test? Thanks in advance.
What is the best way to take the herbal antibiotics? On an empty stomach? Before or after a meal? Before bed?
Hi Sylvie, Did you ever find out the cause of your constipation? Did it get better after treatment for SIBO? Do you have to take the prokinetics forever?
Hi Amanda,
I believe the cause of the constipation was the SIBO. As for the cause of the SIBO, I have my hunches but have not definitively confirmed it. It would require more invasive tests and since both the SIBO and the C have resolved I haven’t found it necessary.
No, you shouldn’t have to take the prokinetics forever. Your doc will likely tell you to take them for 3 months at least.
Hope that helps!
Sylvie
Hi Sylvie,
I have been suffering from SIBO for a few months now, and was finally just diagnosed after having some tests run. The antibiotic normally prescribed for SIBO is not available to me because for some reason my insurance won’t cover it… (I was told they won’t cover it because they don’t think I need it, even after seeing my results) So, that was pretty upsetting for me, as I just feel awful all of the time now and would love to get back to being healthy again. So I started doing research and found your site, and bought your ebook… but I have a question. If I start doing the herbal supplements, the allicin, the neem, and the berberine, do I need to stop taking other supplements that I take? I currently do a multi vitamin, a B12 vitamin, and a Calcium supplement, and since my doctor refuses to tell me how to treat sibo with herbal antibiotics, I don’t know who else to ask. Just wanted to know if there are interactions that could happen with the allicin, berberine, and neem with other medications/supplements that I take? Also, can another brand of allicin be taken if it is still 450 mg, or is Allimed the only one that will work?
Thanks!
Hi Sarah,
Sorry to hear you’re getting the run-around. Of course, I’m not a doctor. The supplements you’re on seem pretty innocuous but in general the recommendation is to keep taking your medication (prescriptions, if on any) but discontinue everything else while you’re on the protocol (your gut will have enough else to process).
I’m not familiar with any other alternative brands to Allimed so at this time can’t recommend them. Hope you feel better soon!
Sylvie
Hi Sylvie,
Was just wondering about your herbal antibiotic regime, if doing a months treatment instead of two weeks do you recommend the same dosages/strengths?
Many thanks
Helen J
how did you use the arsenicum album…very interested
Hi Sylvie,
I wanted to know what your timeline was between your sibo protocols? Or what you would recommend as I presume you can’t do back to back elementals/herbals etc. I had hydrogen and methane sibo (Hydrogen dominant) and did 3 week elemental after which hydrogen eradicated but left with a higher methane result. I then did one month herbal and still have positive methane. I was thinking of elemental plus herbals this time and was wondering how much time to leave before safe to start. Would be wonderful to get some advice. Tx so much
Kind Regards Helen j
Hi Sylvie,
Love your site!
I’m taking herbal abx for SIBO w constipation… Should I stop taking Prescript Assist (soil-based probiotics) while I’m doing the herbal abx?
2nd – what are some cheap prokinetics? I’m broke from this ongoing health saga…
thanks!
Hi Sylvie,
I live in Vancouver Greater Area (GVA) in Canada, and all the doctor that I have visited have no idea what SIBO is until I flew to Hong Kong in March to see a GI there who diagnosed me with SIBO. Due to the lack of SIBO knowledge in GVA, I have been unable to get the SIBO breath test and have been sick since Sept 2015. Your website has helped me significantly in terms of dieting and I am planning to start taking your recommendation of herbal antibiotic treatment. However, I would like to start the breath test first before the antibiotic treatment. Do you have any suggestion on how to properly prepare for the breath test?
Thank you again for sharing your treatment plan. I really appreciate that.
Sincerely,
Cammy
You’re welcome Cammy! For the breath test they will give you all the instructions on how to prepare with certain things to avoid eating for 24 hours before. I wrote more about breath testing, here: https://hollywoodhomestead.com/breath-tests/
Hope you feel better soon.
Sylvie
Hi I had 3 SIBO breath tests – all negative – current symptoms are bloating (get really bad bloat with any fiber even a small amount) and i also have severe geographic tongue and histamine issues. i take a multi bifido supplement whihc improves stools. if i take with larch arabinogalactan it improves my stool even more but also bloats me. does it sound like i may have SIBO even though all my tests were negative? thanks
Last January I took antibiotics for SIBO and felt great for 2 months. My gut distension/bloating went away in a week of taking the antibiotics. Now it’s back and I’m trying the herbal method which is the same treatment as you suggest. It’s been 2 weeks and I don’t feel any different – still stuffy, bloated, distended guts. Does the herbal route take longer?
Hollywood Homestead Thank you again Sylvie. I work for Alaska Airlines.. Hope to see you up there sometime!!
HI Sylvie,
Tx for reply.
I was taking lactulose as it softens stools and I am severely constipated from the sibo, but I think it’s counter productive because it is a sugar containing 0.1 % fructose and 1.6g galactose, 10g lactulose…I’m not sure but need something whilst doing sibo treatment stomach so painful and distended. I understand you are not a doctor regards the breath test, I just wanted your opinion as from all sibo info on web with those results say I should be sibo d not sibo c?
I have decided to do the elemental because of the shorter treatment time as the bloating, distension and constipation are unbearable.
Tx
Helen J
Hollywood Homestead …yeah I mean it would probably mean that I’d have to take 2 weeks off of work if basically he body weakens up… for now it’s not so doable :/
Hi Sonya,
If you think you can handle elemental diet I’d probably go that route to get it dealt with quicker. I wrote all about it here: https://hollywoodhomestead.com/elemental-diet/
Hope that helps,
Sylvie
Dino,
Honestly, I’m not sure if it’s 100% necessary. I did use them although the research was split under the idea that it certainly couldn’t hurt.
Hope that helps,
Sylvie
Hi Helen,
I can’t interpret your lab tests- you need to consult with a doctor. Why are you taking lactulose??
What SIBO treatment have you done so far?
Sylvie
HI Sylvie,
I wanted to ask you can I take laxatives on a daily basis whilst treating my sibo? And also which type you may recommend, I have idiopathic slow transit constipation since childhood but since sibo have dry stools the size of raisins….very peculiar! I have been taking lactulose but think this might be counter productive at it is an indigestible sugar.
Also I am confused why I have constipation when I have high hydrogen breath test…surely it should be sibo-d?
Maybe I am misinterpreting the results? Perhaps you could clarify for me.
This was my breath test results:
Baseline hydrogen level normal at 0ppm(normal<10ppm), methane increased at 17ppm(normal
Hi Helen,
I can’t interpret your lab tests- you need to consult with a doctor. Why are you taking lactulose??
What SIBO treatment have you done so far?
Sylvie
wanted to ask you can I take laxatives on a daily basis whilst treating my sibo? And also which type you may recommend, I have idiopathic slow transit constipation since childhood but since
So happy to hear that Rod! I totally get the need to want to stay on them but you can’t do that forever 🙂
The post sibo treatment diet is pretty important but you’ll have to do what you can. I would suggest you take prokinetics and retest. Then based on that test decide if you should do another round of herbals or just stick with the prokinetics and do your best with the diet.
Hope that helps and maybe I’ll see you in the sky! (I fly a lot) What airline (if you can say)?
Sylvie
Hi Sylvie,
I have suffered from SIBO for years without any real relief from pharmaceuticals. Just finished one month of your herbal antibiotic regimen and I feel fantastic. For the first time in years I am no longer constipated and bloated. I have been regular for the past two weeks and am pinching myself because this can’t be for real. Is there a maintenance dose I can do with the same herbs? Say, take the dose recommended on the bottles? I don’t want to stop because I haven’t felt this good in years but don’t know if it will be bad for me in the long run. I am a flight attendant and adhering to strict diets is very difficult with being on the go all the time but I do try. Thank you again, Rod Massey
So happy to hear that Rod! I totally get the need to want to stay on them but you can’t do that forever 🙂
The post sibo treatment diet is pretty important but you’ll have to do what you can. I would suggest you take prokinetics and retest. Then based on that test decide if you should do another round of herbals or just stick with the prokinetics and do your best with the diet.
Hope that helps and maybe I’ll see you in the sky! (I fly a lot) What airline (if you can say)?
Sylvie
Hollywood Homestead Thank you again Sylvie. I work for Alaska Airlines.. Hope to see you up there sometime!!
HI Sylvie,
I wanted to ask you can I take laxatives on a daily basis whilst treating my sibo? And also which type you may recommend, I have idiopathic slow transit constipation since childhood but since sibo have dry stools the size of raisins….very peculiar! I have been taking lactulose but think this might be counter productive at it is an indigestible sugar.
Also I am confused why I have constipation when I have high hydrogen breath test…surely it should be sibo-d?
Maybe I am misinterpreting the results? Perhaps you could clarify for me.
This was my breath test results:
Baseline hydrogen level normal at 0ppm(normal<10ppm), methane increased at 17ppm(normal
Hi Sylvie! Do you recommend staying on herbal antibiotics for a few months if bacterial level is high? (128 ppm) thank you!
Hi Sonya,
If you think you can handle elemental diet I’d probably go that route to get it dealt with quicker. I wrote all about it here: https://hollywoodhomestead.com/elemental-diet/
Hope that helps,
Sylvie
Hollywood Homestead …yeah I mean it would probably mean that I’d have to take 2 weeks off of work if basically he body weakens up… for now it’s not so doable :/
Hi Sylvie! Is it necessary to use biofilm busters when you use herbs for treating SIBO? Thnak you 🙂
Dino,
Honestly, I’m not sure if it’s 100% necessary. I did use them although the research was split under the idea that it certainly couldn’t hurt.
Hope that helps,
Sylvie
Hollywood Homestead Thank you so much!!! I appreciate it!
Try the SIBO center in Oregon. They do skype consultations
The dosing of Berberine is explaned in the post above 🙂
I did a whole post on breath tests here: https://hollywoodhomestead.com/breath-tests/
Jenny, please check with your doctor. I wouldn’t do herbals and xifaxan at once
Yes Bethany- I no longer have SIBO. It has also worked for many others as you can see in the testimonials for my ebook on this page: thesiboebook.com
Hi Sylvie! Thanks for this super helpful information! Do you feel “cured” after this protocall? I have SIBO and yeast. Grr! I’ve done this before, but that time, I focused on yeast, and not the SIBO. Plus, I wasn’t cognisant of the MMC and keeping things moving, etc. So, this time, I’ll do what you suggest–WITH the prokinetics AND sorry of an elemental diet concept. I’m just looking for reassurance… Did this work for you? Is there light at the end of the tunnel?
Thanks so much in advance! –Bethany
Yes Bethany- I no longer have SIBO. It has also worked for many others as you can see in the testimonials for my ebook on this page: thesiboebook.com
Hollywood Homestead Thank you so much!!! I appreciate it!
Hi there!
I’m currently reading the SIBO solution and was wondering if you recommend the SCD Intro Diet at all or did you not do that one? Since I’m a non-producer and therefore breath tests don’t work for me, I’m just guessing from my symptoms that I have SIBO and would like to try I dietary approach before I resort to antibiotics, even plant-based ones. I just started the SCD intro diet 3 days ago and feel that it’s not only crazy restrictive but also an insane amount of animal protein. So I’d much rather transition straight to the SIBO diet but am unsure how to start on that one? Thanks for your advice.
Dani
Hi Dani,
I didn’t do the SCD intro. If I would have done diet only I would have done the SIBO diet as in the ebook but I only did that for post-SIBO treatment.
If you think SCD intro is working for you, give it a try. Keep an eye on how you react to high fodmap foods on that diet.
Hope that helps,
Sylvie
I’ve been treating my SIBO with a 14 day regiment of the Xifaxan (and the SIBO diet) per my nurse practitioner (including going 100% gluten-free, dairy-free and caffeine-free). I’m supposed to do a 2nd round of Xifaxan after a week off, but I’d prefer to switch to the herbal course you recommend. I intend to add in a 100billion CPU probiotic the 2nd 14 days (I’ll probably continue the herbal remedy for 30 days), but want to be sure that’s ok to do with the herbal antibiotics…any interactions between the herbals and the probiotics? My guess is no, but I thought I should ask. Thanks!
Jenny, please check with your doctor. I wouldn’t do herbals and xifaxan at once
This is super helpful. Is there a 3 hr lactalose for methane/hydrogen one can take at home? The doctors in the Phoenix area are completely inept. I’m told no one does the testing here. I’ve seen multiple different doctors. Most don’t even know what sibo is even in GI. And neither of the two acupuncturists and Chinese medicine doctors did either. My gp has been in practice over 40 years and doesn’t even know what sibo is. The gastro I went to simply shrugged and said we don’t do that test and we don’t know who does. And the last one told me you can only get sibo if you’ve had surgery. Yes people this is western medicine at its finest. (Face palm.) I’ve gone through multiple different protocols many times with worsening results. Or they just didn’t work. Fermented foods and probiotics were like pouring gasoline on a fire. I have no guy motility but all the prokinetics massively exacerbated everything. My system is already terribly sensitive. My diet is so limited it makes fodmaps look like a cheat day. I got a script for the medications by practically breaking into tears with pub med journals in hand but insurance won’t cover it. It’s 1200$. And as I’ve seen so many times may not work or need to be redone. I would really like to get tested to be sure but no one can even tell me how to get the testing done. I’m all but positive it would be methane and not hydrogen. I was tested for hpylori and I think hydrogen is tested there. I would think something would have been detected but possibly not. It was a quick test.
I did a whole post on breath tests here: https://hollywoodhomestead.com/breath-tests/
Hi Sylvie – I just wanted to share with you that my latest SIBO breath test has come back all clear!! Thank you so much – this is only the case because of following your guidance and ebook (I’ve been doing SIBO diet and just one round of herbal antibiotics – and my numbers were severe before – combined hydrogen & methane peak of 288!). Now I’m just keeping on with prevention – diet, prokinetic, ACV&honey, and l-Glutamine, and about to add in 24hour yoghurt. I can’t thank you enough – after over 5 years of torment I am finally getting free. Amanda x
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Hi there,
Thanks for all your info. I had a question about herbal abx side effects. I’m treating what I believe is SIBO- unable to find an MD to test- and have started on oregano, berberine, and neem but I’ve been so bloated since starting this regimen, as if I need to be even more bloated. Does this sound familiar as a normal side effect? I’m about 2 weeks into it but it’s very frustrating. Any thoughts?
Many thanks!
Hi Lindsey,
Yes, it’s quite possible that’s die off. Are you not taking Allimed?
I would definitely suggest testing when you’re done.
Sylvie
Thanks for your ebook and blog, it all has been very helpful!! I’m following your suggestions to a ‘T’. Your steps and explainations have been the most detailed for pre and post treatment I’ve found. I’ll keep you posted on my progress. I have a few questions – How long did you stay on your prescription prokenetic (Erithromycin-50mg) post Elemental Diet and HerbalRx treatment? Did you stay on it after the 3 months? What symptoms did you have to continue if you stayed on it longer? Also, is it assumed that all SIBO patients have a MMC issue even with SIBO-C or SIBO-D? – Steph
Hi Sylvie- I wrote on this board a year ago, and I am sad to say I am largely still stuck. I was finally able to find a chiropractic physician who asked an M.D. doctor to order the 3 hour lactulose breath test for me. (They all think I’m crazy.) My Chiropractic Physician doesn’t even know how to understand the results. (it’s from Commonwealth Laboratories) I just got the results back. At 120 min. my hydrogen level jumps to 16, and then to 35 at 140 min. My methane levels are pretty low and consistent, with the highest being 5 at 140 min. The test says I am positive for SIBO, but the doctor says I am not. His suggestion is to just take some herbal antibiotics for 6 weeks, but I don’t know if I will be able to retest through him. I guess my question to you is, do you think this is something I can get through myself since my levels aren’t super high, or would you still recommend calling the Oregon SIBO center? I am very broke, it has been 5 years of test after test after test. But if this is the end of the road I can do it. Do you know if a remote doctor like the ones in Oregon are able to order the breath test for me, or would I need someone local to do it? I don’t know why I am so bloated if my levels are not that high. I look like I’m 9 months pregnant. When I eat lowFODMAP AIP it does go down some, but never completely.
I am also going to have to do 6 weeks of IV antibiotics for a chronic bacterial infection, and I don’t know whether to wait until my SIBO is cleared up so my gut is less permeable, or do both simultaneously. I feel like I am never going to get out of this cycle. I feel like I have tried everything. I even did elemental diet on my own a year back, but did not include the herbal abx. I have been wondering if you think it would matter to put the amino acid powder for the elemental diet inside gelatin or vegetarian capsules? I can barely get that stuff down and I am dreading doing it again. I wondered your opinion on that.
Hi Sylvie– thank you for all this info, incredibly helpful! I have two questions for you– have you heard of Dysbiocide and FC Cidal for treatment and do you have any thoughts on that course as the herbal antibiotic treatment? And then, in terms of the herbal course you’ve outline above– I realize you were on the elemental diet. But if someone is not, then is it best to take the herbs with meals or on an empty stomach? Does it matter? Thank you again for all this! Amazing articles!
All this info is fantastic, thank you! I see your herbal course and it seems very reasonable. I’m curious as to what you know about another course of herbal antibiotics that you don’t mention in your blog: Dysbiocidin coupled with FC Cidal. Have you heard of this being an effective option as well?
Hi, I can’t seem to find this answer anywhere in my research and am hoping you can help….. Is a prokinetic still needed if you have SIBO with diarrhea, not constipation? I’m guessing you don’t because clearly that means slow motility isn’t the problem… but then I’m wondering what to do instead (to keep it from coming back)
Thanks!
Hi Sylvie, thank you again for all of your helpful advice 🙂 I’m going to start Iberogast once I’ve finished my course of herbal antibiotics, and just want to make sure I get the dose right! You and Dr Siebecker say 20 drops before bed (so I guess that means without food) – but the bottle itself says take 20 drops 3 times a day before or with meals. Is the SIBO dose lower (and a different time) than general usage? Thank you, Amanda x
can low stomach acid be the cause of SIBO? i really hope the healthy vegetables that gives me trouble would be in my diet someday.
Sylvie- do you remember what the milligrams of Berberine you took per day was?
Yoou’re welcome Lisa 🙂
Meant to actually thank you Sylvie- as well as Hollys input!
Yoou’re welcome Lisa 🙂
Sylvie- do you remember what the milligrams of Berberine you took per day was?
Thank you for this wonderful info Holly. Because of you, ive had recent major improvement in my diagnosed SIBO, while avoiding having to pay $200 for Xifaxin. I am curious what dosage of Berberine you took, or that you recommend? The one I purchased is 900 mg for 2 capsules, which it says to take once a day. Wondering if I should be taking more frequently to get rid of this whole thing more effectively? I’ve been doing the Neem 2x a day and garlic. Any input would be greatly appreciated! 🙂
The dosing of Berberine is explaned in the post above 🙂
Thanks for posting Holly. Do you know of any SIBO doc in Washington D.C. area? Or elsewhere in the U.S.?
Try the SIBO center in Oregon. They do skype consultations
Dawn Zitzka Yes, it does. I was SIBO-C mostly so when I talk about my experience it’s in regards to that but at some point in the journey I switched from high methane to high hydrogen so we get into that as well.
Looking forward to hearing your success story in the near future 🙂
Sylvie
I see that some of the commenters here state they found Slyvie’s websirte from a popular Facebook SIBO group. I would LOVE to be added. Can someone please give me the info to any SIBO facebook groups? Thanks! 🙂
Hollywood Homestead – Thank You so much! I did buy one bottle of Allimed and Neem- Beriberi – and Emulsified Oregano. (I felt the most results from the Allimed and Orgegano)and did a 14 day course. I am better but not cured. I am allergic to eggs so no Interphase. Just bought a Bioflim disruptor called “Bioflim Defense” by Kirkman. I am lucky enough to get Rifaximin from Kaiser for only a 35$ copay, but it is sitting on the shelf until I decide what to to next. Since I am Sibo-C, I know I need to do more than just the Rifax, I was thinking of doing the Rifax with the Bioflim and see what happnens next. Does your Ebook cover both SIB-C and SIBO-D?
Kristina, Glad you like the site 🙂
The herbal abx shouldn’t cause constipation. I suggest you consult a doctor to see what protocol is best in your case. I do not have an alternative to Interfase Plus to recommend but you can try searching for “vegan biolfilm disruptors” and find a few ideas to run by your doc.
Wishing you the best,
Sylvie
Holly Carter Beck do you plan to consult a doctor?
Hi! I’m so happy I found your website, and finally figuring out what’s wrong with me. Been to numerous doctors, and all of them just wanted to prescribe me with anti-nausea, anti-acid, anti-anxiety meds, without performing any tests whatsoever.
Currently, I’m more on a IBS-D/SIBO side. Do the herbal antibiotics cause constipation, or is this something people have to begin with? Would you have taken them if you had SIBO/IBS-D?
Also, Do you know of any vegan alternatives for Interface Plus?
Kristina, Glad you like the site 🙂
The herbal abx shouldn’t cause constipation. I suggest you consult a doctor to see what protocol is best in your case. I do not have an alternative to Interfase Plus to recommend but you can try searching for “vegan biolfilm disruptors” and find a few ideas to run by your doc.
Wishing you the best,
Sylvie
Hollywood Homestead I chose not to use the Allimed because (1) it is radically expensive and (2) I heard that a lot of people experienced stomach upset from it. My stomach is sensitive, so I didn’t want to risk it when there were other alternatives.
Holly, Are you not doing Allimed as part of your herbals? Curious why not.
If your die off symptoms were that severe I doubt you’d be able to tackle this with just diet but you can certainly give it a shot. My guess is it would take years. I would consult a SIBO doc to get a protocol tailored to you.
I’m sorry to hear you’re not feeling well.
-Sylvie
I had high nopes for healing, but had to stop my herbals after 5 days. I was taking cinnamon, neem, and berberine and had ever-increasing upset stomach and D; by day 6 I couldn’t continue – had to get out of bed in the night for bathroom trips, etc. No good.
I’m not sure what I should try now… Can diet alone clear this up?
Holly, Are you not doing Allimed as part of your herbals? Curious why not.
If your die off symptoms were that severe I doubt you’d be able to tackle this with just diet but you can certainly give it a shot. My guess is it would take years. I would consult a SIBO doc to get a protocol tailored to you.
I’m sorry to hear you’re not feeling well.
-Sylvie
Hollywood Homestead I chose not to use the Allimed because (1) it is radically expensive and (2) I heard that a lot of people experienced stomach upset from it. My stomach is sensitive, so I didn’t want to risk it when there were other alternatives.
Holly Carter Beck do you plan to consult a doctor?
Holly Carter Beck You’re welcome!
Hollywood Homestead Thank you!
Taking it with meals would be best- it can be a bit rough otherwise. I did it with elemental diet so those were the “meals”. I definitely noticed some discomfort when I took it away from my “meals”. Hope that helps!
My appologies if someone has already asked this – do you take the herbal antibiotics with meals or between meals?
Taking it with meals would be best- it can be a bit rough otherwise. I did it with elemental diet so those were the “meals”. I definitely noticed some discomfort when I took it away from my “meals”. Hope that helps!
Hollywood Homestead Thank you!
Holly Carter Beck You’re welcome!
Madeline Rosie Hewitt You’re so welcome 🙂
Hi Dawn,
I was on my usual diet, not a SIBO specific diet while treating. As for biofilm, I took Interphase Plus between meals. It is a biofilm disruptor.
Hope that helps!
Glad you like the blog 🙂
Sylvie
Hi Sylvie! I reallyt hope you can respond to my question. What did you EAT WHILE you were on the herbal protocol for SIBO? I have heard some people, like Dr.Pimetel, to feed the bacteria during treatment so they don’t hide in the bioflim. But he mostly uses Rifaximin. Some people have said they take in morning and night on an empty stomach, or 20 minutes before each meal. i have been taking mine with my meals, but wonder if there is a better way because Allimed is EXPENSIVE! love to hear from anybody on diet DURING treatment. Thank you so much for your work and blog! 🙂
Hi Dawn,
I was on my usual diet, not a SIBO specific diet while treating. As for biofilm, I took Interphase Plus between meals. It is a biofilm disruptor.
Hope that helps!
Glad you like the blog 🙂
Sylvie
Hollywood Homestead – Thank You so much! I did buy one bottle of Allimed and Neem- Beriberi – and Emulsified Oregano. (I felt the most results from the Allimed and Orgegano)and did a 14 day course. I am better but not cured. I am allergic to eggs so no Interphase. Just bought a Bioflim disruptor called “Bioflim Defense” by Kirkman. I am lucky enough to get Rifaximin from Kaiser for only a 35$ copay, but it is sitting on the shelf until I decide what to to next. Since I am Sibo-C, I know I need to do more than just the Rifax, I was thinking of doing the Rifax with the Bioflim and see what happnens next. Does your Ebook cover both SIB-C and SIBO-D?
Dawn Zitzka Yes, it does. I was SIBO-C mostly so when I talk about my experience it’s in regards to that but at some point in the journey I switched from high methane to high hydrogen so we get into that as well.
Looking forward to hearing your success story in the near future 🙂
Sylvie
Hi this was a great post.
I’m from the UK and can only find one brand that looks good and strong enough but on Amazon they seem to try to trick you by using different dosage lingo, one brand claims to be the only one that’s pure enough yet only states 180mg strength vs this one that’s 400mg apparently.
I’m so ill with SIBO I need to start acting now. I’m not sleeping because my distention is so bad with almost everything I eat. I think this happened because of the extremely long time I’ve had symptoms and resorted to junk diets when I’ve felt like nothing was working, and I only found out about SIBO this year, I know I will need some seriously strong stuff as I’ve abused my digestive tract for 6-8 years… I ate a lot of healthy food but a lot of bad stuff too….
I really need help, and if anyone knows affordable naturopaths in the UK please send me some info as I am currently too ill to work and don’t have a lot of money to throw around.
I wonder also if I should combine allicin with berberine, which seems to be more for IBS-D people, I’m IBS-C, and almost certainly therefore a methane based issue..
I also (was) vegetarian and hate eating meat, but it’s one of the ‘safest’ things for me at the moment. Really ripe bananas and berries seem fine too.
Michael.
Hi Michael,
Have a look at this one- seems like it’s in the UK and it’s 450mg, right?: http://www.allicin.co.uk/product.php/13/23/allimed_reg__100_capsule_pack
I wouldn’t go with the 180mg one. Have you considered elemental diet for faster progress?
Hope you find relief really soon!
Sylvie
Hey Sylvie,
Thanks for sharing so much good information. iam having hard time digesting the food(side effects of Nexium for 4 months and antiobiotic Pylera capsule). since with SIBO we have to most of time surviving on Meat which is too hard for me. not tested for SIBO at. when i requested my doctor to test for it he said if i had SIBO it would be treated with refaxmin. 14 days course of rifaxmin didn’t help me in any way on the contrary it made me worse.I am planning to visit other doctor who can prescribe me the SIBO Test . if we do elemental diet do we still need to take pro kinetic? how long did you take pro kinetic. are you still have to be on pro kinetic? do you take any other supplements like HCL and digestive enzymes after your treatment? did you give acupuncture a try. i see some people say it helps. my Indian doc prescribed GANATON OD 150 MG which is pro kinetic do you think this is fine?
You’re welcome Danielle! Yes! You can do quite a few herbal teas- just make sure they’re not on the “NO” list in my ebook. I did mostly peppermint and ginger tea.
You are a wonderful woman! Thank you for sharing!! Do you know if all herbal teas are okay while on an ED? I’m dying and want to enjoy tea every day but want to be careful. Your thoughts are appreciated!
You’re welcome Danielle! Yes! You can do quite a few herbal teas- just make sure they’re not on the “NO” list in my ebook. I did mostly peppermint and ginger tea.
Hi Sylvie,
Do you have any remedies for constiption during this process?
Hi, I’ve been on 14 days couse of xifaxan for my sibo and I had only a very small improvement during the treatment than I was taking ginger and iberogast but unfortunatelly after I stopped antibiotics my digestive tracks slowed down so badly that my gut are almost not moving at all for last week. i have severe heartburn and constipation. I’m also badly underwaight because I can’t handle much food because of my SIBO, so I guess elemental diet is not for me…..So I have a question, when you were taking natural antibiotics did your symptoms vanished compleately at the end of the treatment? Or did you got better gradually after ypu finnished antimocrobials? Do you think that taking only herbal antibiotics and diet without going on elemental is enough to got rid of my sibo? I also have a question about testing because I can’t find the test that shows both methane and hydrogen in my coutry they check only hydrogen, when you were tested did they use gastrolyzer thing to check both types of gas? I will be very grateful for answer. Thank you.
Hi Anna,
Why did you discontinue the prokinetics? Those should help your motility issues quite a bit. If you’re underweight already, you’re right that Elemental might not be right for you. I do think you’ll be able to eradicate without elemental- it just might take a bit more time and patience and several courses of herbals.
I wrote quite a bit about testing here: https://hollywoodhomestead.com/breath-tests/
Make sure you check out all the posts in my series if you haven’t already: treatingsibo.com
Hope that helps! and hope you feel better soon.
Sylvie
thank you very much for your help, I didn’t discontinue prokinetics after xifaxan I was taking Iberogast, ginger and 5htp regularry but despite that symptoms came back. Maybe my course of xifaxan was too short. What do you think, can I start retreatment a week after I finnished xifaxan? Symptoms came back and I have to go to antoher side of my country to make retest….and symtoms are bacamimg unbearable….Initially I was tested only for hydrogen and it was high (98 ppm) I have not been tested for methane though because it is unavailable in Poland where I live. But this is weird because I’m more prone to constipation and no diarrhoea at all. I saw a difference when I was on xifaxan but it was not compleat relief (maybe treatment was too short). So could you please help me and write if herbals you have been using for your sibo (allicin, neem, berberine) are as efective for hydrogen as for methane? Or should I use different options if I have high hydrogen level? Maybe I’m high in mehane too but unfortunatelly I have no chance to check it in my country so I will be forced to try if their helped my symptoms. But the thing is is there any difference with healing methane and hydrogen by herbs? Are doses and type of herbals the same for both kind of gases? And what is the longest time that herbal treatment for SIBO can last? Is it good idea to eat some carbs during treatment in order to activate bacteria? What are your thoughts on this? Thank you so much!
Anna.
Hi Anna,
I wish I could answer your specific questions but a) I’m not a doctor and you’re at a stage where you really need so see one and b) I don’t have enough information to give you the answers you need.
I don’t want to steer you down the wrong path. I highly recommend you book a skype appointment with a doctor at the SIBO center in Oregon, US. They should be able to help you.
Hope you feel better soon,
Sylvie
Hey sylvie,
Sorry for so any questions . I am planning to take elemental diet as well do you know if unsugered aborb plus is as effective as the nestle?
Do you know if they do SIBO tests in india
Thanks Sylvi, did you had malabsorption of nutrients while you had SIBO I lost 30 pounds in last 4 months
I did not lose weight during the time I had SIBO. As for malabsorption my guess is yes I did.
and also do you know any doctors treats SIBO in Newjersy. make some personal appointments as well
Hi Raj,
I’m sorry but I can’t communicate via email. I love answering comments here so the answers can hopefully help many. I don’t know any SIBO docs in New Jersey but the SIBO center in Oregon does skype consultations. Hope that helps!
Sylvie
Thank you very much Sylvia . Did you mean semethicone OT drug. Is there any email id I can interact with you.
You’re welcome Noa! I have heard of it but haven’t used it personally. If you do, feel free to update here with your experience! 🙂
Thanks for all the time and energy you put into this. I’m wondering if you’ve heard of Metagenics as an herbal antibiotic. Specifically their Candibactin.
You’re welcome Noa! I have heard of it but haven’t used it personally. If you do, feel free to update here with your experience! 🙂
Hey, My doctor prescribed refaxmin 550mg. while you were taking these did you had any side effects and also did you take PPI during the course. whic i think PPI caused the issue for me.
Hi Raj,
You can read about my experience with Rifaximin here: https://hollywoodhomestead.com/antibiotics-for-sibo/
I did not do PPIs while treating SIBO.
Hope that helps,
Sylvie
Thanks Sylvie!!!! And also can you provide the naturopath doctor who you worked in skype . And also did you had heart burn during this if yes any remedies and also for bloating stomach any remedies
Hi Raj,
I’ve worked with several doctors. My recommendation would be any doc from the SIBO center in Oregon (Dr. Siebecker, Dr Hayes etc). Some of them are more available than others but they all know what they’re doing. I didn’t have heartburn. For bloating enterocoated peppermint oil seems to help some people. I didn’t notice it to be too helpful. The bloating will go away after you erradicate SIBO but in the meantime you can try some of the detox protocols I mention here to see if they help: https://hollywoodhomestead.com/ways-to-detox/
For severe painful bloating you might want to go the conventional route and try an over the counter gas relief like dimethicone temporarily. There’s no reason for you to suffer in the meantime but know you need to treat the root cause in order to eliminate the discomfort permanently.
Hope that helps!
Sylvie
Hi, I have done the organic acid urine test 2 years ago and it was high in Benzoate, Hippurate and D-Lactate. I was pregnant at the time and couldn’t follow up with a herbal protocol, just changed my diet and supplemented with Saccharomyces boulardii. It helped but now it’s back and I would like to follow the herbal protocol. I am still breastfeeding, the baby is now 20 month, will I be able to take the herbs? Also is it ok to drink homemade kefir and kombucha while doing that? Many thanks, the article is super helpful!
Hi Radka,
I honestly can’t advise as to doing the protocol while breastfeeding. I would wait till you wean but you can check with a SIBO doctor who perhaps will give you a modified version of the protocol.
And no, I would not drink kombucha or kefir or take any probiotics while doing that.
Hope that helps,
Sylvie
Hello Sylvie, I just got diagnosis of SIBO (by breath test, my hydrogen level was 98). I also just found out that I have h.pylori i my stomach. I have very sensitive stomach the only things that doesn’t bother my stomach are coocked chicken, eggs or coocked vegetables. Even suplements like licorice DGL betaine HCL or l glutamine cause heart burn and stomach pain. I aslo have problem with blenching and bloating after meal. I have constipation type of SIBO. I’m going to start the treatment but in my country (Poland) doctors are not well informed about SIBO so I have no other choice than find out good treatment by myself. Maybe you coud heplp me. My questions are:
1 What could I do to prepair my stomach before treatment (many natural antibiotics like pepper mint or garlic cause severe stomach pain and hearburn i my case, so I’m scared that rifamaxin and herbals may do the same).
2 Is it good idea to combine both rifamaxin and herbal atibiotics? O may I try herbal tratment just after I finnish rifamaxin to help eradicate bacterias?
3What do You think about grepefruit seed extrac as natural antibiotic for sibo?
4 What do you think about LDN prokinetic? Can I combine it with herbal prokinetics?
5 Should I start prokinetics with antibiotics treatment or better just after it?
6 During the antibiotic treatment should I keep diet (I heard that sometimes it is better to eat carbs while taking antibiotics so I’m confused..).
7 How Long schould last diet after recovery and when I can start eat more carbs?
8 Do you recomend taking digestive enzymes while treatment or after?
9 what can help with multiple foods sesitivity?
10 when should I start takin suplements that helps with gut’s regeneration (like L glutamine)…
I’ll be very gratefull for giving me some help with that…
Regards Anna.
Hi Anna,
Sorry to hear you’re not feeling well. Have you considered doing the elemental diet? https://hollywoodhomestead.com/elemental-diet/ I wouldn’t advise all the “combining” options. Choose just one treatment to start and re-evaluate after that. Have you read all 10 of my blog posts on SIBO? A lot of your questions are answered in some of those posts: https://hollywoodhomestead.com/treating-sibo/
I wouldn’t worry about the before and after of SIBO right now- focus on eliminating it first before you think about post treatment diet and gut healing.
Hope that helps and hope you feel better soon.
Sylvie
Than You very much Sylvie. I’ve red all of your’s 10 blog posts about SIBO, and again thank you very much for what you are doing because there is so much very helpful informations for people who are scaried that they can never be healthy again. I still could not find information about what to do If have h pylori infection and SIBO at once. I’m pretty much sure that h pylori is one of the main cause for my SIBO and I don’t know If I should treat h pylori first or first get rid of SIBO? Can I treat H pylori with mastic gum while taking antibiotics for sibo? Or should I wait until I finnish antibiotics? Also one more question: because of SIBO i have huge vitamins and minerals deficiences so can I take vitamins while taking antibiotics ?? Can vitamis feed bacterias?? Please if you could be so kind and give me answers for that. Thank you very much for your time and help.
Anna.
Hi Anna,
You should probably focus on treating one at a time. I think trying to get rid of both together would be tough. You and your doctor should decide which you treat first. I had both but I treated H. Pylori first because at the time I didn’t know I had SIBO. I wrote about it here: https://hollywoodhomestead.com/how-to-treat-h-pylori-naturally/
The vitamins won’t feed SIBO but you might have trouble absorbing them during the die off. I would wait till you’re done treating so you don’t waste your money. If you do the elemental diet there are vitamins included in that protocol.
Hope that helps,
Sylvie
Hi! Thanks so much for this Sylvie! I think sugar is a big trigger for me and I am going to try the elemental. I want to cut out the honey (for the homemade recipe) and consume NO sugar for 2 weeks (just the aminos and oil). What are your thoughts on this?
Hi Morgaine,
I totally get you on that but without some form of carbohydrate (honey, dextrose, something…) it’s not a complete elemental diet. I would suggest running it by your doc to see if there’s a carb you could use (in the minimal amount needed) that won’t trigger you.
We do have to have some carb in there to make it a complete diet.
Hope that helps!
Sylvie
Sorry to hear that Anna! If you decide to finish your allimed course see if taking it with food helps a bit.
Be careful about spending so much money on Allimed. I’m so dissapointed. After spending so much money, after a few days, it gave me stomach upset! I’ve contacted the company to try to get a partial refund. Wish I had purchased Kyolic garlic instead, which supposedly is dry and does not have the the usual irritating effects of raw garlic.
Sorry to hear that Anna! If you decide to finish your allimed course see if taking it with food helps a bit.
Hi Sylvie, I am looking for some guidance. 4 weeks ago I woke up severely bloated, and a bit distended (probably around the 3 month pregnant looking stage, not huge but huge for me!) At first, my GP treated me for a parasite (I rescued a dog who was being treated for Giardia) so I took a one week supply of flagyl, but then the stool test revealed I did not have giardia or another parasite. The flagyl did not relieve my symptoms at all.
I have had abdominal, pelvic ultrasounds, as well as blood tests and the one stool test and my GI simply said “we can do an upper endoscopy but if these symptoms continue it’s likely just IBS”
I am 26 years old, no history of GI issues. I immediately cut out gluten in hopes that would relieve the bloating. I have now also been avoiding high-fodmap foods for over a week and still feel no different. I am much less bloated upon waking up but still more bloated than usual, and by lunch I am back to 3-month-pregnant looking. I wake up every morning to terrible stomach cramping until I have a bowel movement (sometimes D, sometimes normal) and am just not sure where to go from here.
I asked my GI about sibo treatment and he said he would not order the test as it is very inaccurate but would treat me for it via antibiotics if I want. Should i try it even though the flagyl provided me with no relief? Also, what supplements should I look into taking? I am currently taking a probiotic and a digestive enzyme but have read about so many others that could help.
Any guidance and advice would be appreciated, I am young, eat very healthy, active, and just want to live my life like normal.
Hi Brooke,
I totally relate to your frustration and I’m sorry to hear about your discomfort and your doc’s reluctancy to test. The #1 thing I would advise you to is consult a SIBO specialist who WILL test you (3 hour lactulose test). If you don’t have a local SIBO specialist I would consult with a doc at the SIBO center via skype PLUS get a new local GI that will order the test for you. Expensive, yes. But it will be the fastest way for you to know for sure if you have SIBO and going from 1 treatment to the next will become expensive and exhausting.
In the meantime try to stick to the diet I mention at the bottom of this post (more than just low fodmap and more than just 1 week) to see if that relieves symptoms at all. https://hollywoodhomestead.com/sibo-diet/
If you do go with your GI’s plan of assuming you have it and treating with antibiotics (I’m assuming Rifaximin since Flagyl clearly didn’t do anything for you) make sure you follow the advice on prokinetics and diet that I mention in this post: https://hollywoodhomestead.com/antibiotics-for-sibo/
Hang in there Brooke! It won’t always be this way. Keep taking proactive steps to get it under control and you’ll get back to normal.
Hope that helps,
Sylvie
Niten Bhargava definitely a good idea to discuss with your doc! Just keep in mind that the overgrowth is not necessarily bad bacteria either.
Hollywood Homestead Thank Sylvie- I just read that if you are killing off all of your good bacteria then it leaves spaces for other bugs to grow. Will discuss more with my doc
Thank you! I’m so grateful for your blog!
Niten Bhargava
No prob 🙂
No I don’t but if you have a yeast overgrowth you should definitely check with your doc as to how they want to tailor your plan to make sure it doesn’t get worse or that you can tackle both at once. I don’t think you need to worry about probiotic enemas. You can deal with probiotics after the SIBO is gone. Focus on eliminating that first.
Hope that helps!
Sylvie
Hi Madeline,
You can take it both during and after. (That’s what I did although eventually stopped the iberogast and kept up just the motilpro and erithromycin)
Hope that helps!
Sylvie
Should Iberogast be taken during the elemental diet and herbal anti-biotics? Or should I wait until I’m done with both the diet and the anti- biotics?
Hi Madeline,
You can take it both during and after. (That’s what I did although eventually stopped the iberogast and kept up just the motilpro and erithromycin)
Hope that helps!
Sylvie
Thank you! I’m so grateful for your blog!
Madeline Rosie Hewitt You’re so welcome 🙂
Hollywood Homestead Thank you very much Sylvie!! do you recommend taking saccharomyces boulardii during the SIBO eradication? i read this enhances sIgA and also curbs yeast overgrowth. Or do you recommend taking rifaximin with an antifungal as well? Also do you feel it may be a good idea to do probiotic enemas so at least the bacteria in the colon will not be compromised during the SIBO treatment? Many thanks
Niten
Hi Niten,
It doesn’t surprise me at all that you got worse after a course of Rifaximin. That’s what happened to me as well as I mentioned in this post: https://hollywoodhomestead.com/antibiotics-for-sibo/ but I do think not taking prokinetics immediately after the course of abx was likely one of the big problems.
Any change you can do a breath test for SIBO to be sure? Make sure it’s a 3 hour lactulose test or don’t bother. I wrote more about testing here: https://hollywoodhomestead.com/breath-tests/
If you DO have SIBO I would wait on the gut healing with L-Glutamine etc until after you’ve erradicated the SIBO. Leave probiotics and fiber out until then too.
Hope that helps! – Sylvie
I just finished the 2 week course of Xifacan and have been eating low FODMAPs for weeks (still eat dairy, however). My SIBO breath test numbers seemed high – 147 for hydrogen and 12 for methane. I felt much better after a few weeks of the diet and the antibiotics. However, my GI specialist is silent about when I should retest, how to help my MMC, what the cause of my SIBO might be, and has never mentioned anything other than this antibiotic and to come back in a few months. Can you recommend a good specialist in the Boston area? How about my taking natural microbials prophylactically? Thanks for your great site!
Hi Veronica,
Glad you like the site! If your results were as high as 147, I would be shocked if a 2 week course of Xifaxan did the trick. I would retest 2 weeks after you finished antibiotics (read more about testing here:https://hollywoodhomestead.com/breath-tests/) and take prokinetics immediately (that will help your MMC do its job). I don’t know of a specialist in the Boston area but I would make an appointment with someone at the SIBO center for a remote skype consultation. That will greatly help you navigate this. I’d love to know your test results if you feel comfortable sharing when you retest.
Best to you!
Sylvie
hello Sylvie- My name is Nitin. I am pretty certain I have SIBO although 2 of my breath tests were negative. I took stool tests through out the years and they always show dysbiosis with low lactobacilli and bifido. A recent stool test said i was severely deficient in sIgA as well. Also i took a few metametrix tests and they always show different parasites; i gave up on those tests cause they were expensive and not reliable in my opinion. I did a course of rifaximin a few years ago and i felt better but as soon as i stopped the symptoms came back. So now i want to do a long term treatment with biocidin and take supplements to heal my gut (glutamine, etc). my question is do i take probiotics while trying to treat SIBO or will that just add fuel to the fire? I know the colon needs probiotics too. Also i like to take daily fiber supplements but i know they can act as prebiotics so not sure if i have to cut that out too. any information would be appreciate. Thanks 🙂
Hi Niten,
It doesn’t surprise me at all that you got worse after a course of Rifaximin. That’s what happened to me as well as I mentioned in this post: https://hollywoodhomestead.com/antibiotics-for-sibo/ but I do think not taking prokinetics immediately after the course of abx was likely one of the big problems.
Any change you can do a breath test for SIBO to be sure? Make sure it’s a 3 hour lactulose test or don’t bother. I wrote more about testing here: https://hollywoodhomestead.com/breath-tests/
If you DO have SIBO I would wait on the gut healing with L-Glutamine etc until after you’ve erradicated the SIBO. Leave probiotics and fiber out until then too.
Hope that helps! – Sylvie
Hollywood Homestead Thank you very much Sylvie!! do you recommend taking saccharomyces boulardii during the SIBO eradication? i read this enhances sIgA and also curbs yeast overgrowth. Or do you recommend taking rifaximin with an antifungal as well? Also do you feel it may be a good idea to do probiotic enemas so at least the bacteria in the colon will not be compromised during the SIBO treatment? Many thanks
Niten
Niten Bhargava
No prob 🙂
No I don’t but if you have a yeast overgrowth you should definitely check with your doc as to how they want to tailor your plan to make sure it doesn’t get worse or that you can tackle both at once. I don’t think you need to worry about probiotic enemas. You can deal with probiotics after the SIBO is gone. Focus on eliminating that first.
Hope that helps!
Sylvie
Hollywood Homestead Thank Sylvie- I just read that if you are killing off all of your good bacteria then it leaves spaces for other bugs to grow. Will discuss more with my doc
Niten Bhargava definitely a good idea to discuss with your doc! Just keep in mind that the overgrowth is not necessarily bad bacteria either.
I’m so happy I finally found someone who understands this nightmare I’m going through for the last 5 years! Thank you so much for this site. I am positive I have SIBO. Mine stems from a neck/spine injury that interfered with my thyroid and hormones and many other systems like digestive. I’m in treatment for the neck injury. I found a functional medicine practitioner who is helping me but is maybe not as knowledgeable about SIBO as she could be- I took the breath test today so I’ll have to wait a few weeks for results plus a few weeks to get an appointment- but I was going to start Dr Siebecker’s homemade elemental diet along with Dysbiocide and FC Cidal in the meantime because I can’t stand living with this distended abdomen and having nothing fit me and having stiff joints and inflammation- In your opinion is there any harm starting this now? It sounds like people are needing to do more than one period of treatment- I don’t know what herbal antibiotics she’ll tell me to use, I almost want to just take what you listed and give that a try, because I don’t think this practitioner has treated SIBO before. She is willing to work with me though.
I also have a systemic bacterial infection (high mycoplasma pneumoniae) and my other doctor wants me to do 5 weeks of IV therapy to finally get rid of it. It’s Clindamycin, and I’ll need to do it twice a week for 5 weeks. I worry that that will make my leaky gut even worse, and I’m thinking that maybe I should let my gut heal before doing that. I also wondered if the herbal antibiotics I take for the SIBO could possible get rid of the bacterial infection as well. Any thoughts you have about what you would do would be helpful- I’m finding that I can’t get help from just one doctor, so I’m seeing 3, and none of them are knowledgeable about the whole picture….
Hi Kristy,
So glad you’re finding this helpful and so sorry you’re dealing with all this.
Is there any reason you can’t switch to a SIBO specialist? If your doc isn’t familiar with SIBO I worry it would be an uphill battle for you.
Because it sounds like you’re dealing with more than just SIBO I’d say you might want to wait to have results before you start treating to make sure you’re going about it the most efficient way.
If you absolutely have to stick with the doctors you’ve got, make sure to hand them a copy of my articles 🙂
Treating SIBO ineffectively can get expensive really quickly.
Hope that helps!
Sylvie
Sylvie – great article on diets!! I’ve been on Dr. Siebecker’s SIBO diet which is a combination of FODMAP’s and SCD as I understand it. And I’ve had to religiously stick to the “green” column, even then there are “allowed” foods that I react to. For example I cannot eat coconut flour, oranges, or any nuts other than peanuts. However, I don’t seem to have an issue with eggs or aged cheese, so in that respect I have it better than others!
I have a good friend who also has SIBO and her doctor has her on a blend of pharmaceutical and herbal antibiotics, but has not given her any diet restrictions at all.
So far, from my limited experience, I think both diet AND medications are absolutely vital to correcting the issue. But I understand how very difficult it is for some people to adopt such a restrictive diet.
Thanks again for all the great info on your fabulous blog!!!!
You’re welcome Shawn. Thanks so much for reading and commenting. Hang in there, it won’t be this restrictive forever. 🙂
Hi Sylvie,
For the interfase plus, did you take it with meals or away from food?
I spoke with Dr. Hayes on Thursday and I’m starting rifaximin tomorrow! With S boulardii, interfase plus, partially hydrolyzed guar gum, and possibly Iberogast in the evenings as well.
THanks!
Christopher
Hi Christopher,
Away from food for the interfase plus. Exciting! Would love to hear how it goes for you!
Don’t forget prokinetics when you’re done as well (iberogast or whatever you and Dr H agree on).
Best to you!
Sylvie
I’m trying to decide / figure out which probiotic to go for. Any suggestions?
What did Dr. Hayes suggest? I’m taking Prescript Assist and so far so good although it does seem to contain PREbiotics as well. Dr. Siebecker thought it would be fine and I’m limited in options here in the Middle East so I thought what the heck. 🙂
Hi Sylvie – thanks so much for all of the great info!! I was diagnosed with SIBO about 9 weeks ago – both methane and hydrogen type.
I’ve taken 6 weeks of Candibactin AR and BR, I am currently on a 4 week cycle of NeemPlus, and after that I have 6 or 8 weeks (I can’t remember exactly at the moment) of AlliMed. I’m also taking InterFase Plus. It sounds like my treatment is much more drawn out than yours was, but my doctor has had great success against the more difficult methane type SIBO with this regimen, so I’m very hopeful!
I have a couple of questions for you:
1. In your experience, do you think it is possible to have SIBO for years? I’ve had SIBO symtpoms (IBS) for at least 10 years. I only just found my amazing doctor and was diagnosed this past spring, but could I have really had it that long?
2. Do you think SIBO causes hyperpermeable intestinal membrane? If so, and if I have had SIBO for 10 years, how long could I expect it to take to kill the SIBO and truly heal my GI? How much damage could the SIBO have caused in that amount of time?
3. I could tell I was making great progress on the Candibactin, but since I’ve been on the NeemPlus cycle, I feel like I’ve lost some of my forward momentum. Do you think the NeemPlus is as effective as the Candibactin?
4. Currently, I am still unable to tolerate fibers and starches. I’ve been on Dr. Siebecker’s SIBO diet sticking to the strictly GREEN column for 9 weeks. I have tried to venture into the YELLOW column with poor results. How long did it take you to successfully reintroduce starches or fiber into your diet? Were there “allowed” foods on your diet that you found you could not tolerate? My diet is so restricted right now and I would love to add some variety, but every time I try it seems to set me back. I feel so frustrated that after 8 weeks of treatment I am still not able to tolerate more foods. You mention in your article that following the FODMAP diet is not a good long-term strategy. However, I am beginning to worry that it could be my only option.
5. At what point in your treatment did you start taking a prokinetic?
Thank you again!
Shawn
Hi Shawn,
Glad you found it helpful. Here are some answers for you:
1. Yes absolutely possible and would not surprise me at all.
2. Absolutely causes it. According to Dr. S the gut often heals itself (slowly but surely) when SIBO is eradicated. I like to a more proactive approach and focus on some gut healing after elimination but don’t worry about that now. Focus on eliminating SIBO as that’s a heck of a task in and of itself.
3. That’s interesting and a great thing to stress to your doc. I wonder if the Berberine in the Cadibactin is what you were reacting well to? Maybe your doc can add Berberine to your Neem Plus protocol? I can’t image Neem Plus alone would be effective. I took it with the whole cocktail listed in the post above.
4. It’s not surprising that you still can’t tolerate many foods. I wouldn’t try reintroductions till after you’re SIBO clear and I would do them one at a time and slowly at that point. I wrote more about diet in this post: https://hollywoodhomestead.com/sibo-diet/ I don’t think diet alone is a good idea for treatment but following treatment and as part of your prevention strategy it’s essential!
5. Immediately after treatment and I’m still taking them- please don’t skip this vital step. Ask your doc which he/she recommends for you.
Hang in there! Hope this helps,
Sylvie
Hi Sylvie,
It looks like Dr. Siebecker’s schedule is booked up for the foreseeable future. Did you work at all with Dr. Keller? I’m wondering if she would be a good option.
I’m still trying to decide whether to go the herbal or rifaximin route, in conjunction with the elemental diet. But it’s so expensive! I could do the rifaximin with my GI doc and my insurance will cover it, but the herbal protocol is $420 I think. Plus the homemade elemental is about $400 according to you, and if I do the herbals, I think I’d want to consult with Dr. Keller in advance so that’s more costs. … Tough to decide.
Can you tell me if you lost weight during the elemental diet? I’ve already been having difficulties keeping my weight up, and even though the calories would be replaced, I wonder if my body adjusting to the elemental diet would result in further weight loss.
The other thing I’m wondering is if the elemental diet could result in further narrowing of my food choices, post-diet. My diet has been getting narrower and narrower over time (I had to go low-fodmaps recently in addition to being AIP), and I worry that reintroducing foods after the elemental diet might be difficult. I know you said to go slow just to let your stomach get used to foods again, but have you heard of anyone who has increased sensitivities after the elemental diet?
By the way, it looks like your link to the Allimed is broken. And you said you need 2 bottles of that for a 14 day course of 1-2 capsules, 3x a day, which I think means you need 84 capsules maximum. So wouldn’t one bottle of 100 capsules suffice?
Thank you!
Christopher
Hi Christopher,
I haven’t worked with Dr. Keller myself but I have worked with Dr Hayes in that same office and she was great as is Dr. Siebecker. I’m sure Dr. Keller would be great as well. I totally understand your concerns in regards to cost. The mistake I often see people make is not investing in a great (SIBO) doc plus testing (and retesting after treatment!) and taking prokinetics.
In your case since you’ve already tried the Rifaximin and also DIY-ing the herbal route I would suggest you see a SIBO doc to help you determine the next course of action for your particular case so that you can get rid of it once and for all!
As for weight loss, I didn’t notice much if any weight loss but it is definitely a concern for those struggling to keep their weight up. You could adjust the calories of course and try consuming more but again this something you need to discuss with a doc.
As for increased food sensitivities, it wouldn’t surprise me, but it’s not permanent. You can rotate foods so that you don’t make things worse. Don’t worry too much about post-treatment just yet. Focus on getting rid of this thing. For later, you might be interested in this post I wrote about food sensitivities: https://hollywoodhomestead.com/food-allergies-sensitivities-intolerance/
Thanks for pointing out the broken link- I fixed that and you’re right it’s 1 bottle- fixed that too! thank you!
Hope you find some relief soon!
Sylvie
Hi Sylvie,
Thanks for the reply – it is really wonderful having someone to talk to who has walked this path already and seen success.
I successfully scheduled a consult with Dr. Hayes for next week! I’m looking forward to that and to her take on things. I think I’ll likely end up doing rifaximin (since my insurance will cover it and I can’t really afford the herbal antibiotics), plus the interfase plus, and motilpro to follow. I might also do the homemade elemental diet if Dr. Hayes thinks that’s a good idea (the cost will be offset by not buying groceries).
So now I’m turning my thoughts towards the post-antibiotic/post-elemental diet phase, and trying to plan out my strategy for rebuilding my gut and reestablishing good gut flora. I think the rebuilding phase needs more attention than I gave it before, so that I don’t relapse again.
Can you give any more details on what you did post-eradication phase?
– Like what probiotic did you use and at what dose? Did you ramp up slowly?
– I’ve also heard that Saccharomyces boulardii can be a good addition, even concurrent with the antibiotics since the antibiotics won’t affect it and it can help prevent a fungal overgrowth from taking advantage of the antibiotic usage. And I did test positive in two stool tests for yeast and candida overgrowths so I’m keeping that in mind too. Did you try that at all?
– Do you have any thoughts about using Colostrum to help heal the gut?
– I’m thinking about L-Glutamine as I mentioned to you before, though I’m not sure which brand would be good.
And then I’m planning to drink a lot of broths and do some castor oil packs and epsom salt baths and fish oil to round out the picture.
I’m also going to plan out the schedule for retesting once I speak with Dr. Hayes and my GI doc.
By the way, my most recent breath test levels peaked at 58 ppm for hydrogen (around the 60 minute mark), and 2ppm for methane around the 30 minute mark. The test went for 2.5 hours total. I think the rifaximin dosage my GI doc is recommending is 550mg 3 times per day for 10 or 14 days (I can’t remember which one). I’ve heard of people with much more elevated numbers. So I’m hoping that since mine are perhaps lower, this dosage will be able to knock it out.
Thank you!
Christopher
Hi Sylvie,
Thanks for this post. I still hvaen’t managed to kick the SIBO myself. I did rifaxamin after the first diagnosis, and then did a round of herbal antibiotics (Dysbiocide and FC Cidal by Biotics Research) after the second diagnosis. But I just re-tested this morning and it came back positive. Interestingly, last time I tested positive for methane dominant SIBO and this time it’s hydrogen dominant. So perhaps that’s progress?
A couple questions for you:
1) For the prokinetics, do you take all three of those (MotilPro, Iberogast and Erythromycin) concurrently? Seems like a lot to take every day. And what do you think of Low-Dose-Naltrexone?
2) I live in Los Angeles so I’m wondering if the doctor who finally helped you with the SIBO is located in Los Angeles? If so, could you email me his/her name? I’ve had difficulty finding a doctor who could give me a comprehensive approach and it sounds like you found someone who did just that. I would like to kick this thing once and for all!
3) You mentioned in one of your posts that testing positive for hydrogen and methane might not indicate SIBO but could actually be due to some other conditions. Maybe I missed it when reading through your posts, but what are the other possibilities?
Thanks!
Christopher
Hi Christopher,
That definitely sounds like progress! And it was exactly what happened to me if you care to take a look at my lab tests in these posts:
My first positive test here (methane dominant): https://hollywoodhomestead.com/breath-tests/
My second positive test here (hydrogen dominant) and also my third negative test further down in this same post: https://hollywoodhomestead.com/elemental-diet/
As for docs in L.A., no. I used the docs at the SIBO center in Oregon and they were all quite helpful in helping to navigate this. In LA though you might want to check out Mark Pimentel (and/or maybe his team) at Cedars Sinai.
As for your other question it’s complicated and a bit of a rabbit hole that most of us have no reason to go down (since the likelihood of it being SIBO plain and simple is quite high) but for your googling pleasure, here’s a start: Staphylococcus aureus,Streptococcus viridans, Enterococci, Serratia and Pseudomonas species.
If you’re testing for both methane and hydrogen though, and seeing a doc that is knowledgable about SIBO, I think that is all you need to worry about.
Most importantly, don’t let that second positive test discourage you. It sounds like you’re getting close to the finish line.
Oh, I almost forgot to answer your Q on prokinetics. Right now I’m only taking motilpro (3 capsules) and erithromycin (50 mg at bedtime). I plan on experimenting with resolor (prucalopride) when I can get my hands on it (tough since I’m in the middle east and they don’t carry it here) but when I do I’ll swap out the erithromycin for that one just to see if I notice any difference. I’ll likely keep myself on prokinetics for quite a while just in case but the doses I was on during treatment are no longer necessary.
I think LDN is helpful for many people. I haven’t tried it personally but if your doc recommends it, it’s worth a shot. I think experimentation is key with prokinetics (since what works for one person might not work for another) but taking one immediately after treatment is crucial.
Hope that helps!
Sylvie
Hi Sylvie,
Thanks for your reply and thank you for your encouragement. I actually gave Pimentel’s clinic a call last week but he’s not taking new patients. One of his associates could see me in March! I’m going to take that appointment but keep working on the SIBO in the meantime and see if I can get it resolved by then.
For the SIBO center in Oregon, did you travel up to see them or did you consult with them remotely?
I’m thinking strongly about doing the elemental diet. I know it won’t be pleasant but I also know I have the discipline to do it hardcore for 3 weeks. After 2 years of super strict restrictive diets, I’m willing to go the distance in order to be able to start enjoying more foods again. And I have plenty of practice sticking to a strict protocol.
I was looking at the Vivonex ingredients and saw that there are some soy and corn based ingredients. I’ve been avoiding those foods for a couple years now so I’m a little apprehensive about using a product that includes them. I also heard of an elemental formula called Vital 1.5, but it also has corn based ingredients, milk ingredients and canola oil. Since the elemental formulas are pre-digested, are normal food intolerances not an issue?
My current GI doc just told me that she recommends taking rifaximin 3x a day for 14 days; I had previously done a round of rifaximin but it was only 2x a day for 10 days. Would doing an antibiotic regimen (herbal or traditional) while doing the elemental diet be too aggressive in your opinion?
Finally, I heard glutamine can help with healing the gut once the SIBO is gone… have you tried that at all?
Thanks again!
Christopher
Bummer about Pimentel!
I did skype appts with SIBO center since I’m in the Middle East at the moment.
Definitely read my posts on Elemental diet and Rifaximin for my thoughts on that. I did do herbal abx plus elemental at the same time. Tough to say for sure, but I think it accelerated progress. It wasn’t fun 🙂
L- Glutamine would be a great post-SIBO gut healing. I’ll write more about gut healing later this year but that would definitely be one of my recommendations. Start with tiny doses though to see how you do. Transdermal is another option there for people that find L-Glutamine tough for their gut to handle (ironically).
Hope that helps!
Sylvie
Is Erithromycin the same thing as Erythromycin?
Hi Timmy, Oops- that’s a typo! I’ve fixed it. It’s supposed to be Erythromycin. Thanks for catching that!
Hi Jen,
Motilpro is basically ginger so sure you could do that and play around with the dose to see what you find helpful. Take it at night before bed since the migrating motor complex works when it’s not dealing with food to digest.
I would definitely retest 2 weeks after finishing your protocol, continue prokinetic (whichever one you decide on) and also talk to your doc about other possible causes.
The thing about treating without testing is that you’re kind of flying blind a bit… You might be treating SIBO when you either have something else or have SIBO PLUS something else. Then I see people get discouraged, thinking they’re not making progress when perhaps you reduced your level 80+ SIBO to 35 which is still positive but it’s MAJOR progress! Then they give up or go down a different rabbit hole, all of which becomes more expensive in the long run than just springing for the breath test now.
Just my 2 cents 🙂
Hope that helps- let us know how you do!
Sylvie
Sylvie, do you recommend any probiotics to use after SIBO treatment?
Jen, I hope to be able to write more on that soon. I’m not 100% decided on the probiotic front but if you choose to experiment with it I would go slow and see how you do.
Hi Sylvie,
I was just recently diagnosed with SIBO and yeast, and my doctor put me on Diflucan for 30 days and Rifaxiimin for 14 days. He also recommended taking VSL3 with the meds to put good bacteria back in the gut. Everywhere I’ve read (your site and Siebecker’s site) seems to say that I should just do the meds first, then slowly add either a probiotic supplement or fermented foods back in. He also said nothing about a motility supplement that you and Siebecker have written about. Do you think I should start with the meds, and also take the Motilipro, and then add the probiotics after treatment? I’m just looking for the right way to treat all of this to avoid relapses. Thanks for your advise.
Hi Jen,
Yeah you’re spot on. I think you should hold off on the probiotics till you retest and see where your levels are and I would definitely do a prokinetic, either motilpro or erithromycin (if your doc will prescribe it) or a combo of both. What were your levels when you were diagnosed? If they weren’t that high this might do it for you.
Hope that helps!
Sylvie
Thanks Sylvie for your advise. I feel like I’m on the right track. I was never breath tested for SIBO. My doctor is basing diagnosis on my symptoms and a stool test. My symptoms are very very similar to SIBO. Basicaly I get a bout of IBS-D (bloating, pain, diarrhea, fatigue) when eating certain foods. Everything was under control for years and then due to poor health (chronic pain, medication, getting away from ferments) it’s crept back in again. The last 4 episodes were within 6 weeks and 2 were from fruit (smoothies) and 2 were from avocados. I asked him for a breath test but he said based on my symptoms and how poor my stool test looks, he’s pretty convinced that’s what I’m dealing with. So I have no levels to report. I know its not good to not have a breath test but maybe at my next appointment I can convince him to try it to see where my levels are after the meds. But also have you heard of using ginger as a prokinetic? A friend mentioned using 1500mg of ginger to help with motility. Any advise on that?
Hi Sylvie, thank you so much for such a wonderful website. I have some questions, I am currently on Vivonex Plus and this is my 5th day. I am having the hardest time with it, it tastes so bad.I am not sure if I can take any herbal antibiotics.I noticed that you have done herbal treatment along with ED. Did it help you? Are you SIBO free? My doctor said I have to be on it for 18 days but I plan on being on it for 21 days. I ordered everything that you have mentioned but haven’t started yet. I also wanted to ask if you have heard of Designs for Health Gi Microb-X Vegetarian Capsules. Also can you drink anything but water with ED? I have been boiling ginger with cinnamon sticks and adding lemon to it and drinking that during the day besides water. Can you have coffee or tea? I am just so desperate for any advice or help. Antibiotics didn’t help me (xifaxan and neomycin), i have been diagnosed with sibo for the second time so started ED in hopes I will be Sibo free.
Hi Sevil,
I feel your frustration. It’s a hell of a process! Yes, I am SIBO free and yes having the elemental plus herbals did help me. If you have a chance read thru all 10 posts in my SIBO series. Antibiotics didn’t help me either (I took the same you did). I did drink a cup of coffee (black) every morning during elemental and also herbal tea throughout the day. Just try to make sure it’s not the ones on the no list mentioned at the bottom of this post: https://hollywoodhomestead.com/sibo-diet/ Off the top of my head, no licorice root tea or chicory root “coffee” etc.
The taste of the vivonex really is horrendous. I don’t think what you’re adding to it, especially since it’s small amounts will be a problem. Stick with it, and make sure to retest a couple weeks after! It’s grueling, but you will feel so much better once you’re done with this!
Hope this helps and keep us posted.
Sylvie
Hi Myra! Thank you! I just replied to your email although it goes to my assistant first so you’ll probably get it in the morning 🙂
I’d go with Dr Siebecker’s recommendation. I haven’t heard that about Berberine but of course everyone is different so I’m not discounting his experience at all. Hope that helps!
Just want to say YOU ARE GREAT! Love your website. Thanks so much. Feel free to ignore my email to you. I have since answered my questions by reading more thoroughly (brain is working slowly these days).
Oh but if I may, a quick question: I notice that Dr Siebecker recommends 4 weeks on the H.A.’s. http://www.naturaldigestivehealing.com notes that Berberine is not for long term use. Hmmm. Any thoughts on this?
Hi Myra! Thank you! I just replied to your email although it goes to my assistant first so you’ll probably get it in the morning 🙂
I’d go with Dr Siebecker’s recommendation. I haven’t heard that about Berberine but of course everyone is different so I’m not discounting his experience at all. Hope that helps!
Thanks Sylvie for the update. I am in the process of treatment for methane type SIBO at this time and just recently (per my doctor) have been doing some exercises to stimulate the vagus nerve (innervates motility of the gut). This may be of benefit for you. The exercises (gargling, singing loudly, stimulating gag reflex) are explained in detail in the book, Why Isn’t my Brain Working by Datis Kharrazian. In 2 days of doing these exercises, I have experienced a significant decrease in abdominal distention and a decrease in magnesium dosage for constipation. I have more question for you? Is your constipation gone.
Hi Tamara- yes! I mentioned that book in one of my posts in the series- forget which one- and in my upcoming SIBO ebook. As far as constipation gone… I take magnesium every night so not sure if I didn’t take it what would happen. I’m hypothyroid and constipation has been an issue for me for as long as I remember so I err on the side of caution there.
Sylvie,
How is your progress with SIBO at this time. Are you symptom free? Have you been able to add in some high Fodmap foods.
Tamara
Hi Tamara, Interestingly, I feel like I get better every day even though I’m not actively doing much of anything for SIBO except continuing prokinetics and going really easy on the fodmaps. I haven’t done a proper reintroduction of high fodmap foods but basically when home I avoid them which I’m used to by now, and when I’m out to eat I don’t worry too much. I used to feel wrecked every time I ate out and now I usually feel ok and occasionally feel some mild discomfort and usually my suspicion is the dairy in a sauce or something like that but sometimes the consequence is worth it. I plan on doing a little more testing to see if I can find out what may have caused it in the first place and also try to narrow down my “no” list of foods so I can know exactly what to stay away from. Hope that helps!
Yes, thank you!!
Anytime! Would love to hear how it works out for you 🙂
Hi casey, just answered your duplicate post in the comments above 🙂
Hi Joann, For some people Rifaximin works- If you do go that route just be sure to retest and take prokinetics afterwards. Although, to be honest, if I had to do it all over again, I would have done elemental from the start plus herbals based on my high levels. Hope that helps!
Hi Sylvie! I did the Facebook commenting thing, but not sure how that works. 😛 I see that you took Motilpro during your treatment…but several folks on the SIBO FB group say to take it after treatment. Any thoughts on that? Can you shed any light on why it would be good to take it during or after treatment? I just started prescription abx today, but I bought Motilpro thinking I would take it alongside my Rx. Now wondering if I should wait until it’s done?
Hi Casey,
If you’re worried about it, you can certainly wait till you’re done. My doc told me to go ahead and keep it during for the second round of my treatment (during the first round of elemental diet with no herbals I only started prokinetics once I was done with treatment).
The role of the prokinetic is to help the MMC do its job. I think after treatment it’s ESSENTIAL. As for during… it’s hard to say but I don’t think it hurts.
Hope that helps 🙂
Sylvie
I see you took Motilpro during treatment…however, a lot of folks in the SIBO group on FB say to take it after treatment. What are your thoughts? Reasons for during it during? Reasons for during it after?
Hi casey, just answered your duplicate post in the comments above 🙂
Do the herbal antibiotics have a risk of killing the good bacteria and causing a yeast infection?
I took rifaximim and neomycin because they do not absorb except for in the small intestine and I did not get a yeast infection .,, but my sibo symptoms are not all gone. I am getting ready to start the neem and allimed but am worried about potential side effects of these? Thank you!
Hi Kelsi,
Ironically, (TMI alert) I got a yeast infection after the rifaximin and neomycin, despite them being non sytemic. I didn’t get one after the herbals. My best recommendation would be to have a doc guide you if that’s all possible and also to do the testing 2 weeks after antibiotics (not wait much longer) to see how they worked so you can tweak from there. ie did they work at all, a little bit etc? I didn’t feel miraculous after finishing either but feel a tiny bit better every day.
Hope that helps! Sylvie
New to the site…thanx for sharing this important info. I wish I had all this info before I went on Flagyl which my gastric physician put me on and then he said he’d rather have me on the Riflaximim but was very expensive. I am in the process of trying to get it a lot cheaper but not sure if I should even take it at this point, after reading your articles???
Hi Joann, For some people Rifaximin works- If you do go that route just be sure to retest and take prokinetics afterwards. Although, to be honest, if I had to do it all over again, I would have done elemental from the start plus herbals based on my high levels. Hope that helps!
Hi Sylvie, thank you for all these articles, they definitely make it easier to find out more about SIBO. Have you made your own formula for elemental diet? Did you add any foods that you were sure wouldnt do any harm – e.g. bone broth? What did you start eating afterwards – did you still do some kind of low FODMAP paleo or something like that? Did you support detox through other ways?
So glad it’s been helpful, Anet! I did both the homemade and storebough elemental (at 2 different times) and wrote all about it in this new post: https://hollywoodhomestead.com/elemental-diet/ I didn’t add any foods because I really wanted to make as much progress as fast as possible. My next post (next week, make sure you’re on my email list!) is all about diet and I have a future post coming up all about supporting detox. But yes low fodmap paleo is a great start and the more detox support the better. My fave are epsom salt baths.
Stay tuned and thanks for reading!
Hi Sylvie .. Are you sibo free now with no symptoms ?
Kristen,
Much better but I wouldn’t say 100% yet despite my test results showing the all clear. I feel better each week but will likely have to be careful with diet for several more months.
I’ve been on herbals for 6 weeks should I take a break
Lauren, I would take a break and test at the 2 week mark (as in, 2 weeks, pretty much precisely, after you’ve stopped herbals) to see what your progress has been, which would help you determine if that’s enough, or if you need to tweak the combo etc. Hope that helps!
Thanks so much for reading and commenting, Stephanie! Glad you’ve found it helpful 🙂
Thanks for the really nice explanation. One simple question : what is the good time of the day to take the herbal treatment (before/after/with meal)?
Hi Thierry,
Good question! With your meal would be best.
Sylvie
Love your very thorough and honest documentation of your journey! I am healing my gut and in turn the SIBO. Slow process but I feel so much better and your article explains is all SO well; I only which I found it sooner. 🙂
Thanks so much Donna! Glad it was helpful!
Thank you for this, I joined the facebook group for SIBO where I originally saw the link for this article. I am looking into antibiotic treatment because Xifaxan did not work! Been on the sibo diet for 3 months. Hoping herbal helps!! -Erica O.
Thanks so much for reading Erica. Interested to hear about your results!
Although I never had a test for SIBO, I know that is what I’ve had. I used the homeopathic remedy Arsenicum album to help expel the SIBO. A monolaurin supplement at the beginning also seemed to help. It still seems to be being expelled (started the supplement/remedy around the first of Feb. this year after having SIBO for a couple years). I’m enjoying your series–very interesting! Thank you for sharing the information!
Thanks so much for reading and commenting, Stephanie! Glad you’ve found it helpful 🙂