This isn't a long-term solution, but if you do have hydrogen sulfide-producing SIBO, it will likely help alleviate symptoms. I would also contrast with this list of symptoms. Dosing is usually around 50-150 mg, but not more than 500 mg per day. But it is tenable to say that almost any symptom could be driven by a problem in the gut. DrMR: And this is one of the nice things, Gary, about the way your lab operates. Unfortunately the treatment for Methane and HS is Rifaximin and Neomycin in combination. So thats light and noise intolerance. So we have to see how this pans out. So hydrogen sulfide, when its in excess, is a toxic gas, like actually literally toxic. (specifically Target Up&Up brand if you are in the U.S. - a cleaner version of Pepto/bismuth) 3.) It takes 30 minutes to an hour for Pepto-Bismol (bismuth subsalicylate) to start working and help relieve diarrhea, upset stomach, and nausea. They could have your standard SIBO symptoms. The Future of Functional Medicine Review: Elemental Heal (Gut Healing Meal Replacements), Future of Functional Medicine Review Clinical Newsletter, gut related disorders such as SIBO, leaky gut, Celiac, IBS, An Effective, Gut-Friendly Meal Replacement Shake, The Two Most Effective Supplements For Your Gut Microbiome, Spotting a Hashimotos Misdiagnosis and Treating The Real Cause, The Truth About Genetic Testing For Your Health, Hydrogen sulfide is a new gas being studied as a cause of SIBO, Specific hydrogen sulfide test not available as of August 2019 (in development). But unfortunatelyafter cleaning up so many of these patients who have been jumped to the new and novel with their providerIve come to realize that we have to start with what we know works first. But Allison, any particulars that youre looking to? It might be parasites. Genetic tests can come with a cost, and not only to your wallet. So its basically about 2000 milligrams a day. Its coming. But the other thing that Ive seen is body pain. Those would be separate. And we can use technologies to augment what were currently using, as long as it works. In the case of hydrogen sulfide dominance however do you think this would be a bad option. I think for the clinician who needs that feedback, this is a great service to the field. And it doesnt matter if you eat a hamburger or if you eat a pancake or if you eat something else. Were working one-third blind here and were in the middle of an age of discovery here in SIBO. So maybe its pushing someone towards constipation. Again, not to bring this back to the same concept over and over again, but Ive been absolutely shocked at these cases that come in and say, Well, Im a chronic case, and theyve seen a few conventional doctors, a few alternative doctors, but oftentimes the approach has had huge gaps. Second, verify the test was performed correctly: did you drink the solution, lab prep, etc. Hydrogen sulfide is a colorless and odorless gas that is produced both by our own cells, and, by bacteria in the large intestine. I dont think it would be necessary, if it was a hydrogen-only clear case and youre not concerned about hydrogen sulfide, right? In summary, testing a low sulfur diet combined with daily Epsom salt baths for 7 days is a great place to start. Serving the San Francisco bay area and distance patients via phone and Skype. Theyve been sick for so long. So I dont like the idea of using that long-term at all, personally. It is typical for people with an excess amount of hydrogen sulfide gas to have their stools turn black when they take bismuth. I hate spam as much as you do. And then we further validate on the research that Dr. Siebecker did, that Dr. Ruscio is going to supply, and theyll talk about this in a moment. I think that could make sense. Now, what could have been going on here is that Im seeing the more challenging patient group, which we know I do just because Im a specialist. Different versions of the test measure your digestion of different sugars. Reducing your intake of sulfur-containing foods, for even a small amount of time, can help your body detox from a clogged sulfur pathway. Now, before I go on, let me just say that I uniformly saw constipation in my hydrogen sulfide patients. People use that word toxic like an adjective. Honestly, it really just depends. Lets go through the checklist that Gary has made, to make sure before you decide its hydrogen sulfide, etc. At least in my opinion, I dont want to paint this picture that if youre struggling with symptoms, that knowing you have hydrogen sulfide SIBO is going to be the one thing thats going to take you from highly symptomatic to totally fine. Part of which are the ones that Dr. Siebecker highlighted for all of us, and thank you to her. Pepto-Bismol is used to treat diarrhea, nausea, heartburn, indigestion, gas, or upset stomach. Usually, with antimicrobials, you will know within a week if it is going to help or not. So it makes sense that these people present generally sicker. A significant percent of patients who are found to have SIBO (small intestinal bacterial overgrowth) may have only abnormal production of hydrogen sulfide, and therefore would not be diagnosed using the hydrogen-methane breath testing equipment. At the same time, it has antibacterial activity that may kill off both the unfriendly bacteria and the biofilms they live in. So, I feel like its essential in a basic way. So moving on in the symptoms, Ive seen bladder irritation or interstitial cystitis. Yes. In This Episode Breath Testing 00:03:56 They showed improvements both symptomatically and with the lab results. Then: 2 months biocidin 2/day followed by 2 weeks Pepto Bismol 3/day. Because thats pretty much how we separate out our SIBO treatments, with the diarrhea usually going with hydrogen and the constipation usually going with methane. Download Episode (Right click on link and Save As). Well, Gary, Allison, thank you for this roundtable. And I just monitor Instagram periodically, but I replied on this one and said, Really? Capsules, tincture or tea. SIBO is a common clinical condition characterized . If theres newer technology, I would assume that manufacturer and others will come up with it. So youll have these, and it doesnt matter if its Monday morning, Thursday afternoon, or Sunday evening. And at the end of the 60-second video, we provide a link with the specific probiotic recommendations based upon this gut-brain connection. And yes, there is some newer information, possibly some newer devices that we could augment to improve it even further. So Ive seen that work. In addition to colon bacteria, people with SIBO can have too much bacteria in the small intestine (where there should only be a small amount) which can ferment carbohydrates and also produce these gases. And as with many that are listening (and those here on this podcast), we always look forward to new technologies, new approaches to evaluating SIBO, and whether or not there are applications to that in treatment. Our Disclaimer and Privacy Policy. Additionally, H2S can also result from the bacterial breakdown of matter, and can therefore be produced by humans and animals in their waste and gas. I think it mightve been six or seven years before I even started teaching about hydrogen sulfide in special classes I would do with physicians. But thats going to be years and years. more commonly linked to diarrhea than constipation. Its just getting the available therapies to work takes time, thought, follow-up, personalization. Approximately 11% of people worldwide suffer from IBS, a. And then lo and behold, I had never shared my data with Dr. Jacobi, but we got together and shared our data and she had the same experience as I did, constipation. Its a number of straws that have to be woven together to have strength and to be able to lead to that improvement that were looking for. We need to validate, is this bacteria in the small intestine where it doesnt belong, or is it not? It doesnt matter what were talking about. Its pretty funny actually. Were calling to be sure that, one, they drank the glucose, and then were going to start asking if there are chronic postprandial symptoms. And I think, unfortunately, its the instinct of a patient to grasp for this one straw that is the thwarting factor. And we get it back in the lab. And I tried that on a lot of patients, and what I found is, it would just immediately come back and I could perceive it just wasnt long enough. On the other hand, when someone has just constipation it usually indicates a methane overgrowth or bloom issue. It works by helping to slow the . And lets not call up the lab (I dont know if theyre in Germany) where theres a urinary hydrogen sulfide test and put all of our eggs in that basket. And my position here is primarily with hydrogen sulfide. Dr. Michael Ruscio, DC: Hi everyone. This medication is used to treat occasional upset stomach, heartburn, and nausea. And I appreciate that both Dr. Ruscio and Dr. Siebecker are participating in this conversation. Look at this. a flatline result in the third hour could indicate the presence of hydrogen sulfide gas. And in terms of sulfur types of foods or supplements, a lot of them are worse from an Epsom salt bath, because thats magnesium sulfate. There are also studies of using bismuth with antibiotics of your choice, really. This can help patients and practitioners better identify the problem, but there's likely no need for a special set of treatments for this specific SIBO type. It can be compounded. And then the last thing Ill say is, when folks are doing studies with regard to hydrogen and methane breath testing, please, please know that if youre doing it right, its all about the prep and the devices used, closed capture devices, and how the laboratory does it. Despite the usefulness of breath testing, it is important to understand that some patients with SIBO may also have too much hydrogen sulfide (H2S) in their bodies, which is not a type of overgrowth that is detectable by traditional breath tests yet. I think where the excitement is coming from for the new technology is that Doctors Pimentel and Rezaietheyre the ones who have invented this technology and are doing the researchhad told me that somewhere between 60 to 70 percent of people who are actually positive for hydrogen sulfide with this new technology are not a flat line. Or what are your thoughts about just adding in some bismuthor something like thatto your approach to treating SIBO, generally speaking, based on the fact that we cant measure hydrogen sulfide right now, and you dont know youre dealing with it? Although it is normal to produce some amounts of this gas, an excess amount can be an indicator of a certain type of gastrointestinal issue. Start course. Id definitely talk to her doctor about this as a reaction like that is pretty unusual. Aerodiagnostics, check them out. Is Berberine the main natural antimicrobial used for hydrogen sulfide sibo? And what prokinetic did you use and possibly still using? Dr. Allison Siebecker, ND: Diarrhea and constipation. DrMR: Okay. 34:42 Treatment for hydrogen sulfide SIBO. And it needs to be a three-hour, because its the third hour thats vital here. So I guess what I want you to know is that diarrhea is what the research is showing, and mine and Dr. Jacobis clinical experience is showing constipation. I also have H2S. If you tend to not do well on lots of meat and lots of vegetables, and you feel better when you have some carbs, some starch, maybe some rice, that indicates to me, okay, lets do a one-week trial on a low-sulfur diet. It has nothing to do with flat line. So I think thats probably where everyone is getting excited. This can help make the diagnosis, but it wont treat the cause. Hear how our team spotted Johns previous misdiagnosis of Hashimotos Disease and customized an effective treatment plan for his constipation and fatigue. Sometimes referred to as "the pink stuff," Pepto-Bismol is an over-the-counter (OTC) medication that is safe and effective for short-term use. A great product that is recommended to test out isBiotics Mo-Zyme Forte. We dont have that technology. I could sit here and name 25 agents: rifaximin, and go down the line. It was actually starting a year ago in spring, thats when the first research studies were coming out with this new technology, and they were finding diarrhea. Bismuth has also been shown to reduce hydrogen sulfide gas in afew studies. Your . So, brain fog, fatigue, potentially high cholesterol and weight gain and higher blood sugar, joint pain, skin lesions. And then, very cautiously and parsimoniously, consider expanding outward to other therapies. So just for people, this is not something that Gary is just paying lip service to and not actually doing. So thats always the kind of thing thats going to happen. Bismuth is one that comes up. So frustratingits been so many years! But I mean it medically. The dose was 524 milligrams, four times a day. Those with a homozygous (two bad copies) genetic mutation in an enzyme called CBS (Cystathionine beta-synthase) may also be at risk, as the CBS enzyme drives the recycling of sulfur-containing compounds. I utilize a branded device and branded kits because theyre the best that Ive come across. And one lady said, What probiotics do you recommend?. So how do you get bismuth? Is it colonic gas? If the SIBO breath test shows zero hydrogen or methane, though, then its possible that the vast majority of the gas produced is something different: its hydrogen sulfide. As an Amazon Associate I earn from qualifying purchases. For a while there, I couldnt tell, is it helping methane? We know that hydrogen and methane breath testing for SIBO is very accurate if done correctly both by the patient, by the laboratory, and by the interpretation of that data. The best practice for Epsom salt baths is to take a hot bath with 4 cups of Epsom salts for 7 days in a row, and then continue to take these baths a few times a week to maintain sulfate levels in the body. Pepto-Bismol has been around for more than 100 years. These are the types of gases that are measured on a breath test. Five of those tablets, three times a day for 10 days, and then drop down to three tablets, three times a day for 20 days. Lets say this technology isnt out for a while, so we need to do something in the meantime. So we get a flat line hydrogen methane breath test. Are we in agreement that thats kind of a high-level hierarchy to help organize all these thoughts for people? Guests Dr. Allison Siebecker, Gary Stapleton, and I discuss the testing methods available to assess and validate your likelihood of hydrogen sulfide SIBO, and their experiences in the clinic and in the lab, respectively. Symptoms usually include bloating primarily, sometimes belching and reflux, and sometimes constipation and/or diarrhea. Its possible that SIBO just isnt the causeit might be some other form of. BONUS: SIBO Research Breakthrough Updates SIBO Research Breakthrough Updates Approximately 400 mcg of molybdenum, also 20 min prior to meals. So in my interpretation, Ill go up to six for hydrogen and three for methane, for the whole three hours of the test. Is there an urgency but then you cant void very well? That sort of thing. GS: Sure, thank you. Its amazing how far weve come and we have farther to go. And the reason why is because were not yet testing for hydrogen sulfide. Its Biofilm Phase-2 Advanced. Each tablespoon or chewable tablet contains 262 mg, and it aggressively soaks up hydrogen sulfide and pulls it out of your body (by turning the hydrogen sulfide into bismuth sulfide). Well, I did try that for many years on many patients and I personally found it to be unsuccessful. The videos are only 60 seconds, talking about the connection between depression and the gut, and how roughly 50% of people who either went on a low FODMAP diet or used a probiotic saw an improvement in their depression. If you follow those simple guidelineseven though sometimes its hard when youre not feeling well, youre looking for anything to make you feel betterI think you have the highest probability of using the hydrogen-sulfide-SIBO-nuanced treatments to your benefit. Both can cause deficiency in molybdenum, a cofactor for the enzyme sulfite oxidase, which produces sulfate. raise the blood levels of sulfate via skin absorption, Anti-Aging Benefits of Glucosamine and MSM, Remove obstacles to cure and give your body the building blocks it needs to heal in just 6 weeks. We might get a 20% gain from one and then another 20% gain from another. buff.ly/3lnV3VA, This week's blog post: Hormesis - The Dose Makes the Poison (or the medicine)! Were getting a lot of those calls in the lab. So they go for the new and novel, at the expense of what we already know can work. Dr. Ruscio is your leading functional and integrative doctor specializing ingut related disorders such as SIBO, leaky gut, Celiac, IBSand inthyroid disorders such as hypothyroid and hyperthyroid. You can see a good list of low thiol foods to stick tohere. As always, make sure to talk with your doctor to determine the best protocol. This was really more like muscle pain, like that idea of fibromyalgia, and not as much joint pain, but more muscle kind of pain. Have you had the IBS Smart blood test? 25 It is usually well tolerated in young healthy adults. And then second, if youre negative or you have this flat line pattern and you have some of those hydrogen sulfide symptoms, consider adding in the hydrogen-sulfide-nuanced treatments to the gut treatment protocol youre going to use. So these are symptoms that I just gathered clinically after many years of observing what I thought to be hydrogen sulfide. So very severe, difficult food intolerances. a feeling of fullness. Today Im here with Dr. Allison Siebecker, and Gary Stapleton from Aerodiagnostics. Its just talk. I will never share, sell, or publish your email address. This does come back to a philosophy of improving ones gut ecology. If this isnt working very efficiently, there may be too much unusable sulfur (leading to sensitivities) and not enough usable sulfur (at the same time leading to deficiencies). The major components of intestinal gas include oxygen, nitrogen, carbon dioxide, hydrogen, and methane. So one of our Instagram posts went out today. But what I think happens all too oftencertainly the majority of the timeis a clinician or a patient overlooks tried and true therapies. These include brain fog, memory issues, redness, fatigue, and other problematic digestive symptoms like diarrhea and constipation seen in IBS. But you do need to have a lactulose breath test, not a glucose. A multi-focused approach works best to treat SIBO and biofilm. Bismuth subsalicyclate (BSS) has been shown to provide up to 65% protection against TD when taken as 2 tablets 4 times per day for a maximum of 3 weeks. So its not like youre going to do things vastly differently. This is an area where I am certainly open. If youve tested for SIBO and your test is negative or its a flat line, the first thing you should do is double-check that you did the test appropriately. So these are symptoms that I just monitor Instagram periodically, but is. Belong, or Sunday evening never share, sell, or publish email! Primarily with hydrogen sulfide, when its in excess, is this bacteria the... To meals are also studies of using bismuth with antibiotics of your choice Really... If it was a hydrogen-only clear case and youre not concerned about sulfide... And youre not concerned about hydrogen sulfide gas in afew studies, it! 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