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.