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SIBO Protocols – A Summary of what I have done to cure my SIBODisclaimer: I am not a doctor. I’ve done a ton of research on SIBO, but I am not an expert. Any protocols you may try after reading this are at your own risk. I highly encourage anyone reading this to find a qualified SIBO professional to be on your team. In my research, the biggest thing I have gathered is that no two cases of SIBO are alike. To that end, many of you may be suffering from other autoimmune conditions, bacterial infections, underlying thyroid issues, etc. This is not the case for me, so if my protocol seems at all oversimplified due to not taking any of these issues into account, it is because they are not problems for me. All of the treatment rounds outlined below were separated by about 2 weeks of just supplements, no herbs/antibiotics.Tests I’ve had done:Lactulose breath test – this was done once at my initial diagnosis, and subsequently took it again early July 2017.Lactose intolerance breath test - negativeTSH, free T3 and free T4 panel – high TSH, normal T3 and T4H. Pylori breath test - negativeIBS Detex (the Quest version of IBSChek to determine if you have high levels of anti-CdtB and anti-Vinculin antibodies) – both negativeLate Jan 2017 to Late Feb 2017: Supplements: L-Glutamine, Iberogast, Melatonin, Centrum Daily Adult Multivitamin, Digestive EnzymesHerbal antimicrobials: Candibactin AR and Candibactin BRBiofilm Disruptor: Interfase PlusI took these for 30 days. I took the Candibactin on an empty stomach (2 caps of each, twice a day) and took the Interfase with it. I later learned in my reading that Interfase should be taken prior to the antimicrobials. I also don’t know if there is significance to taking them on an empty stomach or with food, but I think if you cannot tolerate them (they are pretty potent), you will want to take with food. As far as diet goes, I was not at all strict on diet. I had tried low FODMAP around October of the previous year but saw little to no success with it. I knew after the SIBO antibiotics, I’d have to be a lot stricter with my intake, so I literally treated my body like a human trashcan. If I wanted to eat it, I ate it. Went out to eat a lot, all the gluten, all the FODMAPs were on limits. I may have gone overboard with this. I felt entirely the same throughout the 30 days on herbals, still symptomatic. No changes in bowel movements that I recall.Before my next protocol, I decided to start on the Fast Tract Diet (since low FODMAP had not helped me previously). I adopted a ketogenic version of Fast Tract Diet, eating less than 25 grams of net carbs daily. Here’s a simplified version of what I ate: low Fermentation Potential (FP) veggies; ample amounts of butter, oils, and ghee; eggs, beef, chicken, pork, lamb, and seafood; black tea (I do not drink coffee by choice); heavy whipping cream; hard cheeses (low in lactose) as well as mascarpone and cream cheeses; occasional 5 oz. glass of dry wine; occasional 0.5 oz serves of low FP nuts. I tried to buy organic whenever possible—but it generally does not alter my purchasing decisions (I’ve usually already made a meal plan, and if the grocery store doesn’t have organic tomatoes, I’ll buy regular instead). This is also when I started to add in Betaine HCl capsules with food. I didn’t notice a difference so I discontinued them when the bottle was gone.Mid to Late March 2017:Supplements: L-Glutamine, Iberogast, Melatonin, Centrum Daily Adult Multivitamin, Magnesium CitrateHerbal antimicrobials: Allimed 450mg (2 caps, 3 times a day), Berberine Complex (3 caps, 3 times a day), and Neem Plus (1 cap, 3 times a day)Biofilm disruptor: Interfase PlusThe long talked about but always feared Elemental Diet. I tried this very early on in my kill protocol compared to others. My insurance wouldn’t cover the Rifaximin and I saw no other way, since the herbs clearly hadn’t worked (and I didn’t know which other herbs to try yet either). I don’t regret doing it earlier on, though. I used the Dr. Siebecker’s homemade Elemental Diet recipe from her website (). I used the Jo Mar Black Label Amino Acid blend, celtic salt, organic virgin coconut oil, and dextrose. I set out to go as long as I could, but knew 14 days would be my minimum. I quickly became averse to the coconut oil, so by day 2, I swapped it out for organic extra virgin olive oil instead (side note: I later learned that the recommendation when one is not tolerating the homemade formula well is to experiment with changing your fat source!). I really wanted the Elemental Diet to work, so I also did an herbal protocol simultaneously (though I learned later it isn’t exactly advisable since the bacteria aren’t “replicating” so most likely won’t be killed while being starved). The herbal protocol I used is above. I took the herbs at the same time as the elemental “shake”. I took the Interfase on an empty stomach, away from other supplements.I only made it to 14 days of the Elemental Diet. I think this was partially because of the herbs I was taking simultaneously. I switched from C type to D type throughout the Elemental Diet, and my body ached very badly. I missed food, but I wasn’t overly hungry. I was also low on the amino acids, so I would take that into account for anyone considering a longer Elemental Diet with the homemade formula. Late April 2017:Supplements: L-Glutamine, Iberogast, Melatonin, Centrum Daily Adult Multivitamin, Magnesium Citrate, Sunfiber (Partially Hydrolyzed Guar Gum)Antibiotics: Rifaximin (550mg, 3 times a day) and Neomycin (500mg, 2 times a day)Biofilm disruptor: Interfase Plus (Note: I did not order more Interfase for this round since I wasn’t sure if it did anything to begin with. I had enough for about 12 days however).I stuck to the Fast Tract Diet throughout this round of treatment, though I know there’s a lot of disagreement about whether it’s best to feed or starve the bacteria. I had read a study that had shown an increased efficacy of Rifaximin when combined with Partially Hydrolyzed Guar Gum (a prebiotic), so I used this as a more scientific approach to feed the bacteria (controlled dosing, rather than overdoing it on carbs and sugar). I was on the antibiotics for 14 days. Mid to Late May 2017:Supplements: L-Glutamine, Melatonin, Centrum Daily Adult Multivitamin, Magnesium Citrate, Sunfiber (Partially Hydrolyzed Guar Gum), Resolor, MotilProAntibiotics: Rifaximin (550mg, 3 times a day) and Neomycin (500mg, 2 times a day)My protocol for the second round of antibiotics was almost exactly the same as the first round, however I started taking Resolor (a prescription prokinetic) after my first round of treatment, and continued that through the second round. I also didn’t bother buying the biofilm disruptor again to save on expense (sorry ya’ll, this illness is ridiculously expensive to treat!). June 2017:Supplements: L-Glutamine, Melatonin, Centrum Daily Adult Multivitamin, Magnesium Citrate, Resolor, MotilPro, L. Reuteri probiotic, Homemade 24 Hour Yogurt, Collagen PeptidesStill symptomatic, now reacting more to foods that I’m eating regularly. Doctor recommends ordering the IBS Detex blood test to see if there’s an autoimmune component at play. Also ask for another breath test, which he obliges. I started working with a dietitian that swears by SCD + Low FODMAP, and she encouraged me to try experimenting with adding back some FODMAPs. She also works with other SIBO patients and had an herbal protocol she wanted me to try, so I decided to give it a shot. I also stopped taking all probiotics and fermented foods. About half way through the month, starting to feel improvements. About 60-70% better.July 2017Supplements: L-Glutamine (this ran out about 1/3 way through the month, I don’t intend to buy more), Melatonin, Centrum Daily Adult Multivitamin, Magnesium Citrate, Resolor, Collagen PeptidesHerbal antimicrobials: Atrantil (2 caps, 3 times a day), Oil of Oregano capsules (2 caps, 3 times a day), Allicin (2 caps, 3 times a day) – will rotate off Allicin after 2 weeks, and rotate in Berberine complex (3 caps, 3 times a day)Biofilm disruptor: Lauricidin (1 scoop, 3 times a day)Feeling even better since starting the herbal protocol (though there are times of headaches and one brief bout of nausea). Now about 75-80% improvement. Sticking to lowish FODMAP, I say “ish” because I do experiment with adding in higher FODMAP items to branch out and keep my microbes guessing from time to time. I will discontinue the herbal protocol if by some miracle my breath test comes back negative.Update July 18 2017: I am negative for SIBO! ................
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