Next steps for dealing with methane while not actively killing....

While I wait for my antibodies to clear so my nerves can heal and restore function to my migratory motor complex in the small intestine I need to do something to keep the methane at bay.  I tried a 90 day protocol and that clearly didn't do much at all.  So what to do??  I don't want to dive into more killing so I may go back to the (possible) methane inhibitors.

Methane inhibitors
Red Yeast Rice - we know that Dr. Pimental is testing a lovastatin type drug to see if it inhibits methane production.  See here for information, scroll to bottom.  Red Yeast Rice does contain a natural form of lovastatin. I've used it in the past and was able to keep my methane numbers mostly in the single digits.  Once I got them to a certain level they wouldn't go lower but with Primary SIBO (aka the food poisoning induced autoimmune variety), getting the numbers down and maintaining them seems better than having them go up and down. And, it made goats fart less so why not us :) 

"At the genus level, the predominant archaea in the rumen of goats was Methanobrevibacter, 

which was significantly inhibited with the supplementation of red yeast rice. 

In conclusion, red yeast rice is a potential feed ingredient for mitigation of 

enteric methane emissions of goats." 
https://www.ncbi.nlm.nih.gov/pubmed/27467559

The link above is to a brand I used in the past. I might try a different brand this go 'round.

Ideal Bowel Support - this is a probiotic containing only 

Lactobacillus Plantarum which according to Chris Kresser can degrade methane.  I quite literally have a shelf of this stuff in my refrigerator.  Can't hurt!

Atrantil - This seemed so gimmicky when it first came out.  And there were so many "worked like a charm" and "didn't do squat" type comments on message boards that I really was skeptical. But I listened to Dr. Brown on a few recent podcasts and given my current situation (anti-vinculin antibodies negatively impacting motility) I thought I should at least try it.  It made me feel better, lighter.  I don't know how else to explain it.  I should say that I did use it after fasting so I was already feeling lighter and I do have most my digestive symptoms under control but wouldn't it be nice to be able to expand my diet without the usual repercussions. I think yes!  So I'm going to add it in while I focus on boosting motility and supporting healing.

Prokinetics
Cause if things aren't moving you are just generally screwed.  In hindsight I would have started taking these the second I learned I had SIBO.  Keeping things moving through the GI tract is the easiest way to prevent more overgrowth (in my opinion).  And note, not all of these are actual prokinetics, some have a more laxative effect, I realize that.  Slowing anywhere in the GI is just not good, makes you feel toxic, sluggish and ornery.
  
LDN - Low dose Naltrexone, although it really doesn't seem to actually have a prokinetic effect much if at all.  For those with Primary SIBO, LDE (low dose Erythromycin 50mg at bedtime) or Resolor (Prucalopride) seem to be the prescription of choice.  I don't tolerate Resolor because it has a teeny tiny amount of lactose.  Maybe you are luckier than I and tolerate dairy. Resolor is available through Canadian pharmacies.  I may ask for a script for LDE the next time I'm in office but I just hate the idea of more antibiotics even though it is a minidose. So for now I continue on LDN since it's beneficial for autoimmune issues.

Motilpro - Taken at bedtime, helps stimulate the cleansing waves of the small intestine at night.  In the beginning of my treatment it was recommended to take between breakfast and lunch as well but I don't really eat before lunch so I just wait until bedtime. Sometimes I take Ginger capsules in between breakfast and lunch.  The stuff is mega ginger burntastic so make sure to swallow it down with a LOT of water about a 1/2 hour before you actually go to bed.  

Vagal Tone - This shows some promise.  It was recommended by my ND but sadly I am reactive to the chamomile and it gives me a headache within seconds of application. Ugh! Similar to Iberogast in that you use it with meals and at bedtime, only it's external, apply a tiny dab on your occiput.

Magnesium - Most people recommend Magnesium citrate because it's not absorbed well into the system so does the trick. But it's acidic and can burn on the way out. Yikes!  Oxide is also not absorbed well and is not acidic, but I like a blend, that way your body can use some of the more absorbable forms and the rest can do it's job of pulling water into the colon and flushing the system.  I take it at dinner and bedtime so it can go to work in the evening and overnight.

Triphala - My new love.  LOL!  I used to swear this stuff did nothing but made me super constipated (and frustrated).  Turns out you just need to keep increasing to find your optimal dose.  I take 4 capsules at bedtime unless I've indulged and then I take a couple extra. Carbs and nuts do nothing but stop me up but oh how I love the taste of them!

I used Iberogast for a while but it started to not sit well.  It was the chamomile. Now the company has been sold to Bayer and is either being reformulated or completely taken off the market.  Either way pretty sad since I know it's used by many. I also try to use bitters before meals but got out of the habit and now forget a lot of the time.  These things can have a positive impact on motility as well.

Most of us have heard of the physical things we can do to stimulate the vagus nerve.  The vagus nerve stimulates the migratory motor complex so it's important that it's strong and active.  According to Dr. Kharrazian there is (vigorous) gargling, gagging and singing.  I also know from yoga that breathing stimulates the vagus nerve, most notably deep belly breaths followed by restricting and extending the exhale. It's your exhale that stimulate the parasympathic response. It's easiest to do this lying down.

Gut and Liver Support
Zinc Carnosine and L-Glutamine.  That's really all I have found that isn't mucilaginous and doesn't feeds the darned bugs.  I capsule up my own Glutamine because it's cheaper and I can avoid the fillers.  A lot of people drink it in water and it supposedly helps with sugar cravings, I just never liked doing it that way.  I recently added in a small dose of copper when I take extra zinc, apparently you are supposed to keep them balanced and not take zinc longterm on it's own.  Don't ask me where I read this, I cannot recall.

I always taking some sort of liver support because your liver takes the brunt of filtering whatever leaks through the intestinal wall.  If we are permeable and/or killing, your liver could use some assistance cleaning all that garbage out of the blood stream.  I've taken everything from plain Milk Thistle to ayurvedic formulas to herbal combinations.  I rotate formulas. 

Soil based probiotics remain my protocol (I would call it "my stack" but that seems really weird for some reason!).  I still take both PrescriptAssist and MegaSpore. I've done so much killing since my initial diagnosis that I feel it's necessary to support the microbiome in whatever way I can.  

Nerve Support
For those with Primary (autoimmune) SIBO, taking supplements that benefit nerve healing may be helpful.  It may not, who really knows.  I add Lion's Mane and Sunflower Lecithin to my hot chocolate and take Acetyl L-Carnitine in the morning. They talked about using Lion's Mane and Acetyl L-Carnitine at the SIBO Symposium a couple of years ago. 

The other thing I take that may or may not be of any help at all is Fibrenza.  My ND feels it may help remove antibodies in some way.  I have no idea how that would work but the idea of having something that scavenges the body seems good to me.



Please note - I do not make anything off these links I just included them for ease and examples.  All the links are products that I have used and companies I have purchased from.  Make your own decisions with your healthcare provider and buy from someone you trust.  Personally I don't like to buy supplements off Amazon unless I know it's coming straight from the company itself.  There are many rumors of counterfeit supplements out there.

Fasting vs. Elemental Diet

These are two very different things even though both involve no chewing.

Fasting is no calories, just water (and salt or trace minerals) for hours/days.  You can ease into fasting by drinking bone broth, which is what I tried but need to be somewhat careful as consuming too many calories can turn fasting into a low calorie diet of sorts.  Why does this matter?  When you fast, your body will burn through the energy stores in your liver in 2-3 days, with no other calorie options present it will turn to burning body fat for energy.  If/when you get into this magic zone, leptin, your hunger hormone decreases and your metabolism revs up because energy is required to convert body fat to energy.  That's the very, very simple way of explaining what I understand from listening to Jason Fung and reading The Complete Guide to Fasting.  If you are over 300 calories then your body will not switch into this magic zone, you will remain hungry and your metabolism will not rev up and go into body fat burning mode. It will just slow down because you are consuming both too many and not enough calories. This is the zone many dieters end up in after years of calorie counting, exercise and yo yo dieting.  According to the hosts of Fasting Talk this is also what happens to some people who only eat one meal a day.  Your body adapts to the low levels of calories and you do not lose weight.

The elemental diet on the other hand, if done correctly, keeps your calorie consumption up to your normal levels.  If you do the homemade version and keep the fats high and carbs low you will go into ketosis and much of the initial weight that comes off will be water.  It shouldn't slow your metabolism.  The problem comes in that many people with SIBO end up not digesting fat well so they rely more on carbs, which with the elemental means sugars. This is also the problem with many packaged elemental diet formulas, heavy on sugars and nutrients, not much fat.  Thankfully so far I am not one of these people, protein and carbs give me difficulty, fat not so much.  I sucked a tiny bit of honey out of my son's honey stick at the farmer's market today and have had a headache ever since.  I didn't used to be this sensitive but cutting sugars out has reduced my tolerance. It probably doesn't help that I seem to have some lingering insulin resistance issues as well.  Turns out my BS monitor is wildly inaccurate and needs to be replaced so I don't know this for sure.

Given that my body is not digesting well and I have a lot of lingering methane I am considering the homemade elemental.  First I need to finish eating the perishable food in the house that only I will eat, then I'll decide.

In a holding/healing pattern

Instead of being impulsive and diving right into the next killing spree since my small intestine is still overrun with methane, I'm trying a little patience.  Not my strong suit and if you've read any of my earlier posts you know I was more likely to go stronger, longer which has not been to my benefit.  I tried fasting, lasted two days, which makes sense since SIBO can have such a damaging effect on your ability to digest and assimilate.  So I was talking this through with my coach on Wednesday.  She's more of a business/lifestyle coach, not a health coach but she's so darned good at reading me and getting me to really think things through on my own that I broached the subject with her.  You tell me what to do and I'm likely to push back but lead me there and let me think it's my idea and I'm all in :) . Such is the way of my crazy brain!  

So, a year and a half ago after my last major "I'm going to rotate through ever last antimicrobial in the cupboard in a last ditch effort to get rid of every last archaea" episode, I gained 10 lbs, like BOOM!  This has annoyed the hell out of me for a multitude of reasons, one being I can't get my wedding band on, the other being I feel like a stuffed sausage in my clothes.  So while I say that I want to fast to let my digestion rest what I really want to do is lose these stubborn 10 lbs.  So this was the conversation with my coach, am I really fasting for the right reasons??  Maybe I just need to read The Complete Guide to Fasting again, I said.  She responded, stop reading, you are just giving yourself analysis paralysis, what does your body tell you?  I started to respond again from the head.  No, she said, take some time, lay on the floor, hand on heart and belly and really listen.  I don't have to.  My body is soooo hungry for nutrition, which means fasting will continue to be torture and I should really contemplate elemental if I do in fact want to give my digestion a rest.

I have a bag of the Integrative Therapeutics Physicians Elemental Diet but it's so sugary (dextrose and tapioca maltodextrin are the first two ingredients) that I am too chicken to try it.  I'm afraid it's just going to make me itch like crazy since I react so easily to sugars.  Not to mention that I would have to take antifungals as it can feed yeast overgrowth bigtime.  I'm sensitive to both potato and tapioca so there's that too.  I believe the dextrose is from potato since the formula is corn and wheat free. Those are the major sources of dextrose (potato, corn, wheat).  So back to contemplating the homemade elemental....  so nasty.  Still not sure that I want to go that route but really feel like my body could use the love.  In the meantime I'm stuffing my face with mexican food and contemplating beer :P.