In our previous post, we took a look at the relationship between Hashimoto’s and SIBO (small intestine bacterial overgrowth), if you have not yet read that or aren’t familiar with SIBO please read it here.
SIBO, see part 1 for larger image
In this post we are going to discuss SIBO treatment and solutions. This information came from a lecture I attended in November 2014 taught by Dr. Datis Kharrazian and entitled The Neuroendocrine Immunology of Small Intestine Bacterial Overgrowth.
One important lesson that I have learned after working with over 750 people with Hashimoto’s is that there are 2 things that are really important for getting good clinical results:
#1. Figure out the mechanism. In other words, where’s the problem? With Hashimoto’s it is often in multiple places and it’s not only the thyroid.
#2. Figure out how advanced it is. Hashimoto’s, like all autoimmune disease, is progressive. We have identified 3 stages of progression. (Read here to learn more ).
In a general sense, the further it has progressed the more you must do.
Another really valuable lesson I have learned is that, often, some of the most effective treatments and solutions come from subtraction.
Many common health problems are problems of excess. Too much sugar, too much stress, too much inflammation, too much salt, too many chemicals.
A simple and effective way of treating too much is by taking things away.
If you have insulin resistance or Type 2 diabetes, stop eating sugar and refined carbohydrates.
If stress is killing you, stop doing the things that cause you so much stress.
If you have too much inflammation, stop eating and behaving in a way that causes so much inflammation.
If your sick from too much salt, stop eating salt.
If pollution is killing us and our world, stop using so many chemicals.
Such a simple solution, so hard to actually do.
At first.
The reason is that we are conditioned to be consumers, not subtractors.
However, if you have Hashimoto’s, learning the habit of being content with less (sometimes a lot less) may just be the key to your healing.
Nowhere is this more true than in the treatment of SIBO
Diet Must Be the Foundation of Treatment
With SIBO, the foundation of treatment is diet because many of the bacteria feed on foods that are common in our diets.
And if you’re like a lot of people I’ve worked with you might be asking yourself, “Why not just wipe them out with antibiotics?”
According to the American Journal of Gastroenterology, recurrence of small intestine bacteria after antibiotics is quite high (the most commonly prescribed being Rifaximin).
Many people have to keep taking antibiotics over and over again for months with limited results.
And there is a tremendous cost to your immune system and to your future ability to defend yourself.
(There is no better way to be defeated by an enemy than to give him repeated opportunities to adapt to your weapons.)
The only thing that really works is to do the diet as a foundation and then use something to eradicate the bacteria along with it.
There are a number of herbs that are quite effective for this. Particularly those in the berberine family like goldenseal, coptis, etc.
A pilot study by Spanish researchers found that probiotics worked better than pharmaceutical therapy for patients with chronic abdominal distention and SIBO.
“Based on this pilot study results, we can suggest that the probitoic herein (Lactobacillus casei, Lactobacillus plantarum, Streptococcus faecalis, Bifidobacterium brevis) used has a higher efficacy than metronidazonal in the early clinical response of patients with chronic abdominal distention and SIBO.”
The SIBO diet is a terrific exercise in subtraction and should generally be done for a month or so to get the best results.
Since there are many foods that feed these bacteria, there are many foods that must be eliminated from your diet for this initial period of time.
Foods to Avoid:
Fructose: sugars, artificial sweeteners, corn syrup
Grains: rice, wheat, quinoa, millet, amaranth, and some non grains like tapioca
Legumes/Galactans: beans, peas, chickpeas, soybeans, lentils
Fructan-containing Vegetables: lettuce, onions, artichokes, beets, broccoli, cabbage, brussels sprouts, peas, asparagus, okra, shallots, mushrooms, green peppers, cauliflower
High-fructose fruits: grapes, apples, watermelon, cherries, kiwifruit, bananas, blueberries, mangos
Meat products: Breaded or processed meats such as hot dogs, bologna, potted meats, most cold cuts (added starches) and there are some who say to also avoid beef, pork and lamb.
Foods to Eat:
Nuts: All nuts except pistachios
Vegetables: All vegetables except those listed above
Low Fructose Fruits: apricots, avocados, cantaloupes, grapefruit, honeydew melons, nectarines, oranges, peaches, pineapples, raspberries, strawberries, tomatoes
Meats: chicken, fish, eggs, (and beef, lamb and pork in moderation)
Fats: Animal fat, oils
The first step of treatment involves the diet as foundation and something to address the bacteria (like the herbs mentioned above).
Either during or after that Spartan menu, it is important to address the root causes and related issues of SIBO (read about these in Part I )
These problems include:
1. Too little stomach acid. Here’s the exception to the healing by subtraction rule. If you have too little stomach acid, you need more.
A simple treatment is to take things that boost stomach acid levels such as apple cider vinegar, lemon juice and ginger root.
Supplementing with Betain HCL may also be beneficial (consult your doctor for this).
2. An immune suppressed gut. Often the cause of this is too much corticosteroid treatment and/or too much cortisol from stress.
Here the subtraction rule works quite well. Stop the corticosteroids (unless you have a condition where you must take them) and do something about stress.
A great daily exercise in doing less? Silent seated meditation.
3. Injury to the gut nervous system (The Enteric Nervous System)
This type of neurodegeneration is permanent. However, this nervous system also has remarkable plasticity and a capacity to rewire itself.
There are couple of really important things to do here:
#1. Vigorous, (I mean really vigorous to the point of tears) gargling. Gargle with several glasses of water throughout the day.
This activates part of the nervous system connected to the vagus nerve which has a very strong connection to the gut.
#2. Stimulate your gag reflex. Order some wooden tongue depressors online and gently stimulate this reflex by pressing down on the tongue.
#3. Coffee enemas. Make sure the coffee isn’t too hot, and hold as long as possible. This causes nerve firing in the brain.
Start with a moderate amount and mild coffee, you can gradually increase both the amount of liquid and the strength of the coffee.
(Best to do it in the bathtub if you have one, so you are close to the toilet.)
Good question. You need to treat it for as long as it takes. And you may have to revisit this periodically. Generally speaking, the more severe it is, the longer and more committed you must be to healing it.
This may take several months.
It’s also true that the better you are at really following the diet and not cheating, the better the outcome and the faster your results.
Apex Energetics has recently released 5 new SIBO products and we have started using them with promising results. Click here to purchase from our online store.
What’s exciting for me as a practitioner is that they have adapted some of the formulas we have already used with excellent results and given us another option for people who have complications.
Clearvite-GL
Clearvite-GL: ClearVite-GL™ (K95) is based on Apex’s popular ClearVite™ formula and is designed to offer gastrointestinal and metabolic support.
This formula includes the powerful combination of hypoallergenic nutrients, amino acids, and minerals that other ClearVite™ products have, but excludes sources of rice and pea protein for those with sensitivities to grains or peas, or who require low carbohydrate content.
It also contains no sugars, which makes it ideal for anti-yeast diets. ClearVite-GL™ is also intended to support liver detoxication and chemical biotransformation with targeted nutritional cofactors.
Suggested use: Mix 1 scoop with up to 4-6 ounces of water. Mix well before drinking. Use once a day, or as directed by your healthcare professional.
Repairvite SE
Repairvite SE: RepairVite-SE™ (K98) is based on Apex’s popular RepairVite™ formula and is intended to offer targeted intestinal support.
This product includes a limited amount of ingredients to offer support for those with certain dietary restrictions.
A high-quality, selective blend that includes brush border enzymes, L-glutamine, and zinc carnosine is incorporated to help support intestinal cell metabolism and the intestinal microbial environment.
Suggested use: Mix 1 scoop with up to 4-6 ounces of water. Mix well before drinking. Use once a day, or as directed by your healthcare professional.
Sibotica
Sibotica: Sibotica™ (K97) incorporates key strains of probiotics that are intended to support the intestinal microbial environment, as well as the intestinal mucosal barrier.
This product may also help support the immune system via certain immune pathways. Key ingredients include Lactobacillus casei, Bifidobacterium breve, and Lactobacillus plantarum.
Suggested use: Take 1 capsule once a day, or as directed by your healthcare professional.
Enzymixpro
EnzymixPro: EnzymixPro™ (K99) incorporates a special proprietary blend of various enzymes, including brush border enzymes, that has been designed to support the gastrointestinal system.
This formula combines a broad spectrum of enzymes to help support the digestion of sugars, starches, fibers, proteins, and fats. It also includes HCl for further digestive support.
Proprietary Blend: 1372 mg of Betaine HCI, Pepsin (porcine), Bromelain, Protease I, Protease II, Protease III, Protease IV, Glucoamylase, Cellulase, Sucrase (invertase), Maltase, Phytase, Pectinase, Lactase, Alpha-galactosidase, Lipase, Amylase I, Amylase II, Peptidase.
Suggested use: Take 1-2 capsules once a day, or as directed by your healthcare professional.
Enterovite
Enterovite: EnteroVite™ (K100) incorporates nutrients and a proprietary blend of fatty acids in a formulation intended to support the intestines and intestinal cell function.
This unique formulation is designed for those who are sensitive to certain food components, such as certain starches and fibers, and who want additional intestinal support.
Short-chain fatty acids (SCFAs), normal bacterial end products of complex carbohydrates, play important roles in intestinal microbial balance and function.
Diets that are low in resistant starch and fiber can result in a low production of SCFAs. Key ingredients include butyric acid and calcium propionate.
Ingredients: Vitamin E (as d-alpha tocopherol acetate), Calcium (as calcium ß-hydroxy ß-methyl butyrate & calcium propionate) and a Propriety Blend: 575 mg* of Butyric Acid (as calcium ß-hydroxy ß-methyl butyrate), Calcium Propionate.
Suggested use: Take 1 capsule once a day, or as directed by your healthcare professional.
The Neuroendocrine Immunology of Small Intestine Bacterial Overgrowth, by Dr. Datis Kharrazian, DC, 2014