Knock, knock?

Is anyone still out there??  

So, yes, it's been forever.  I felt pretty good for about a year, working on motility, gut healing and rebuilding my gut microbiome.  Then the election happened and I won't get political but I just tanked from all the stress.  First, my thyroid took a nose dive and I started pushing into Reverse T3.  Worked to get that sorted out, eventually just throwing in the towel and switching from NDT (natural dessicated thyroid) back to Cytomel.  The muscle cramping didn't go away and the itching came back, which are my body's major SIBO signs.  I'm on so many prokinetics that I have the digestion stuff down so it's the only way my body can cry wolf. On New Year's Day I broke down and did a breath test.  Hello Methane!  

Baseline was so much higher than it's ever been.  Super discouraging and I knew I had to know for sure.  Was my IBS due to the two bouts of food poisoning I had in 2010??  I printed out the lab requisition for the IBSChek and presented it to my ND.  Results came back positive on both measures meaning yes, I have had food poisoning and yes, this SIBO is autoimmune in nature.  Even though the events were nearly 7 years ago I still have antibodies well over the cutoff.  Drat!

We know that when SIBO is autoimmune there's not a heck of a lot you can do until the antibodies clear but I added Lion's Mane and Acetyl L-Carnitine back in to support nerve regeneration.

I opted to do Chris Kresser's SIBO protocol because I've tried many of the others.  90 days of GI-Synergy, biofilm disruptors (lauricidin and Interfase plus), probiotics (Megaspore, PrescriptAssist and Ideal Bowel Support) and hydrolyzed guar gum.

Retest last week...

A big ole...  let down.  Are things better?  Yes!  Have my symptoms reduced?  Yes!  Did I expect more from 90 days of protocol?  Hell YES!

So for now I'm trying Atrantil as I hear for some it can really help with methane.  I'm also playing around with fasting.  Not elemental diet, plain old broth only fasting a couple of days here and there.  I feel pretty darn good.  I have a bag of the ITI ED (Integrative Therapeutics Elemental Diet) sitting in my cupboard but I've heard so many stories of "now I have SIFO" or "now I have a horrible yeast problem and it's worse than SIBO", that I'm seriously scared of the stuff.  I do not tolerate carbs or sugars very well at all so there's that too.  Not sure I could stomach going the homemade elemental diet again and that seems to be the only way you can control the amount of carbs.

Oh and can I just say Biohealth rocks for breath testing - Quintron machine, 3 hr lactulose, I did my test on Monday and had the results by Thursday morning.  I NEVER have to go through NCNM/NUNM again.  Woot! Woot!

Results finally - Breath Test #8

Results from May 2015. Breath test number 7.

Results from this month after gacking down guar gum with my herbal kill supplements.  

Not really what I was expecting given that my C and bloating have pretty much resolved. I'm still trying to wrap my head around it.  And it's not negative (like it says) because any methane at or above 3 is positive and really you shouldn't have any methane at all. And if there were no methanogens to eat the hydrogen gas, the hydrogen numbers would be higher. That said, I'm not having any real SIBO symptoms, maybe a little mild bloating throughout the day but not enough to change what I wear (I'm really self conscious when I have a gut and great at hiding it).  I am having D which is a super nice change.  Those with C understand :)

AND notice the date tested is 10/17, a full 10 days ago.  I sent an email questioning why I didn't get the results sooner, especially since I called on the 21st and was told they weren't ready.  Their response:

Hi Shari,

Our turn around time for sending results to the ordering provider for tests taken with kits at home is no later than 2 weeks from the date the completed kit is received in the lab. After samples are tested, they also must be interpreted and the results finalized before we release the results. This depends on how many other kits we received ahead of your kit.

We also do not release results directly to patients unless/until we receive a signed release of information form.

For SIBO tests taken here at the clinic, the turn around time for results is faster, either same day or next day.

Let us know if you have any other questions.

Best,

Audra
--
Audra Lee, M.S.
NCNM SIBO Lab
P 503-552-1931
F 503-444-6709

My response was along the lines of "the numbers are the numbers", it's not like they add any sort of interpretation or add a narrative or really anything.  I also may have said I recommend to others in the SIBO community that they find another lab with a reasonable turnaround time :)

Okay, enough ranting!!  

I'm good where I am so I'm just going to sit on it for awhile, continue with the MegaSpore and hope that the hype is right and it does contain the number one strain used in Europe to treat SIBO.  Although I've never seen anyone from Europe actually talk about MegaSpore or using probiotics in the forums (I guess if their SIBO is gone they wouldn't need to be there too!).  I'll stick with low FODMAPs for at least 6 weeks and decide what to do then.  Until then I'll focus on getting my adrenals and thyroid noodled out.  My worry is until this infecton is gone nothing else will heal.  Guess time will tell!

Guar Gum

Why guar gum?  Who the hell chose it?  Why couldn't it be eat a package of red vines or bag of M&Ms then take your Rifaximin??  It seriously should be something that is at least a treat.  Perhaps- Mix your guar gum in KoolAid or Coke or better yet wine and enjoy.  We all know there are tons of other tasty FODMAPs that SIBO eat.  So curious to know the how and why they settled on guar gum in water...  Haven't we suffered enough!?!?

Chris Kresser with Dr. Pimental!!

Chris Kresser interviewed Mark Pimental

Talking about the guar gum :)

Clinical Pearls from the SIBO Symposium

The webinars from the SIBO Symposium have finally been released. They are a bit hard to hear but I spent a couple of hours last night listening to the Clinical Pearls section that we missed. Providers had the opportunity to come up and talk about cases and things they are trying or noticing in their patients. They each had 5 minutes. Some takeaways: Farshid Rahbar, MD presented on SIBO and tick borne illness (Lyme). He found that patient with abnormally high levels of hydrogen or methane often had tick borne illness. 65% of people that he has seen that have tick borne disease also have SIBO. Dr. Morstein (ND) uses the generic Rifaximin from Canada and has great success but she always pairs it with 1 tsp of guar gum in 8oz of water. She never treats SIBO without including Lactoprime Plus. She has the client take them with lunch. She felt that if you just treated the SIBO you would end up creating a dysbiosis in the large intestine and then you would be stuck fixing that next. (I have to say I kind of agree, after last summer's war against the archaea I ended up with a bad dysbiosis in my colon.) She also uses Hercius Erineus and Acetyl L-Carnitine to help heal any nerve damage in the small intestine. (My guess is this is the product she uses.) Whitney and Stephanie Hayes, NDs presented on SIBO and infertility. They found if they got rid of a woman's SIBO she often became fertile again. Pretty fascinating since you wouldn't think they would be linked. They think SIBO testing should be considered in any woman with pelvic pain/dysfunctions. Dr. Elena Guggenheim talked about autoimmunity and how the bacteroides seem to modulate the immune response. She presented a case on RA and said that once she got the woman's SIBO under control (only symptom was diarrhea), her RA symptoms greatly reduced and she was able to resume normal activities without daily use of medications. Kelly Reis (sp?), ND was great. She bought her own Quintron so she could get results fast. She also does thermography and finds that people with autoimmune issues have a cooling spot above their T2 thoracic spine. (I had this done before my SIBO diagnosis and I didn't have anything blue (cold) in this area. Fascinating!) She runs a facebook page for clinicians which is a valuable resource since everyone seems to be guessing a bit on the harder cases. Nora Jacoby, ND talked about diet. She has a diet handout that she gives patients and there is access to it for clinicians only on her website www.sibotest.com. She gave no details to say how it was different that the SIBO specific diet. She strongly recommends Dr. Kharrazian's gargle/gag method, breathing exercises and use of cascara sagrada. She also mentioned Heart Math (which I really want), to help you get into rest and digest mode before meals and to help train yourself overall to easily get into parasympathetic mode. Using a Squatty Potty or step stool will help retrain the bowels. If you like local and sustainable (aka expensive) go herehttp://gostool.com/shop/ Dara Perkins, MD has found that with low weight SIBO patients she often has them eat high quality fermented sourdough bread and organic corn products such as polenta for a starch and most have success. One of her patients found that if you combine LDN with antihistamines you may have nightmares. Dr. Ruscio came up and talked about how he tracked patients taking biofilm agents and some who were not and so far hasn't found any difference in effectiveness. He will release his finding later this summer. BIofilm disrupters are a must if the overgrowth is fungal.  He brought up how the microbiota is the next big thing but that a lot of the information going around on blogs is not based in research. He's not ready to jump on the feed the microbiota carb bandwagon. He said prebiotics need to be taken on a case by case basis and you should be gunshy with SIBO patients. He is beginning a study of prokinetics in the next 2-4 months. To be in this study you have to be ending your treatment and SIBO clear when he starts his research. Information at www.drruscio.com Mark Davis, ND talked extensively about FMT and said that even when people swallow (ewwww!) an FMT capsule it does not cause SIBO. He bases this on a study where they sprayed fecal material into the duodenum of people and the bacteria migrated back down to the colon. Allison Siebecker, ND indicated that any kind of self care whether it be acupuncture, massage, yoga, meditation, colonics, deep breathing, etc improves patient outcome. Dr. Moore, ND uses a food allergy test to see if patients have leaky gut, if there are lots of positives or mildly positives it indicates leaky gut. (other NDs mentioned this as well). Expressed need for mentoring program for clinicians treating SIBO (the new GastroANP.org for providers will provide some of this). A doctor asked a question about how to regenerate nerve function in the small intestine. The same herbs were brought up (as above) by Dr. Morstein, acupuncture, colon hydrotherapy, cranial-sacral therapy. Dr. Ruscio brought up again that ICC cells will regenerate on their own once SIBO or antibodies are gone. Steven Sandberg Lewis, ND brought up the whole gut brain connection. He said if there has been any mild traumatic brain injury - former soccer player, non-diagnosed concussion, black eye, broken nose, whiplash (me two or three times), any of those impacts can affect the gut neurology. Neurofeedback is a great way to address it. The general consensus with all the providers was SIBO is either easily treated or very, very difficult. There doesn't seem to be a lot of middle ground. Guess I know where fall!