Hydrogen Sulfide SIBO

[TheBrain]

I've been trying to heal my gut for years. It's become even more imperative since learning my ApoE4 status.

I finally have a possibly game-changing gut-related diagnosis! I recently signed up for a three-month online GI Restoration program with a clinic of naturopathic gastroenterologists. The doctor I’m working with directly is Dr. Lauren Steinman, but all three doctors review together the cases of all the patients. Also on staff a nutritionist/mindset coach.

On Monday, I did a breath test for small intestinal bacterial overgrowth (SIBO). I got the results today. I have Hydrogen Sulfide SIBO. It’s a chronic bacterial infection of the small intestine. The overgrown bacteria produce hydrogen sulfide gas, hence the name. Many cases of IBS are actually due to this and other types of SIBO.

(If anyone's interested, I can explain how this diagnosis was determined, based on current breath testing. The recognition of this type of SIBO seems rather new, maybe even cutting edge.)

This finding points to a sulfur sensitivity or difficulty in processing sulfur. I don’t yet know if this is temporary (and will heal after I complete my treatment protocol) or permanent (but manageable somehow). I plan to look into sulfur SNPs.

It’s disappointing to know that I had a SIBO breath test 5 1/2 years ago that showed this exact same pattern of Hydrogen Sulfide SIBO. Unfortunately, my results were interpreted as negative (i.e., normal). Also interpreted as negative was a SIBO test I did two years ago (but the testing period was too short to show the pattern).

Ultimately, this is very good news. The treatment won’t be fun, and I'm trying to figure out what I'll be able to eat. I'm already on a mildly ketogenic paleo autoimmune protocol (AIP) diet. I also avoid my many food I'm sensitive to. Now I'll have to reduce FODMAPs and foods high in sulphur. I’ll get clarity soon. The end goal is to have a healthy gut and an expanded diet with at least some of my food sensitivities clearing once and for all.

[LA18]

TheBrain, I’m sorry to hear that you have SIBO, but glad you were able to get an accurate diagnosis. I am definitely interested in hearing more about the testing you did, as I have unrelenting SIBO (classified as methane dominant). I have been trying to get rid of the overgrowth, which, in my case, is likely due to a motility problem, for years. Eating low FODMAP has reduced my symptoms, and I’ve also found Atrantil, which is designed to treat methane-dominant SIBO, to be quite helpful. But I still have flares whenever I eat anything that is even remotely fermentable. I wonder if sulfur could be an issue for me as well.

[SusanJ]

The end goal is to have a healthy gut and an expanded diet with at least some of my food sensitivities clearing once and for all.

Fingers and toes crossed for you to find the right treatment that works. You are so persistent and it pays off!

[Magda]

I've been trying to heal my gut for years. It's become even more imperative since learning my ApoE4 status.

I finally have a possibly game-changing gut-related diagnosis! I recently signed up for a three-month online GI Restoration program with a clinic of naturopathic gastroenterologists. The doctor I’m working with directly is Dr. Lauren Steinman, but all three doctors review together the cases of all the patients. Also on staff a nutritionist/mindset coach.

On Monday, I did a breath test for small intestinal bacterial overgrowth (SIBO). I got the results today. I have Hydrogen Sulfide SIBO. It’s a chronic bacterial infection of the small intestine. The overgrown bacteria produce hydrogen sulfide gas, hence the name. Many cases of IBS are actually due to this and other types of SIBO.

(If anyone's interested, I can explain how this diagnosis was determined, based on current breath testing. The recognition of this type of SIBO seems rather new, maybe even cutting edge.)

This finding points to a sulfur sensitivity or difficulty in processing sulfur. I don’t yet know if this is temporary (and will heal after I complete my treatment protocol) or permanent (but manageable somehow). I plan to look into sulfur SNPs.

It’s disappointing to know that I had a SIBO breath test 5 1/2 years ago that showed this exact same pattern of Hydrogen Sulfide SIBO. Unfortunately, my results were interpreted as negative (i.e., normal). Also interpreted as negative was a SIBO test I did two years ago (but the testing period was too short to show the pattern).

Ultimately, this is very good news. The treatment won’t be fun, and I'm trying to figure out what I'll be able to eat. I'm already on a mildly ketogenic paleo autoimmune protocol (AIP) diet. I also avoid my many food I'm sensitive to. Now I'll have to reduce FODMAPs and foods high in sulphur. I’ll get clarity soon. The end goal is to have a healthy gut and an expanded diet with at least some of my food sensitivities clearing once and for all.

TheBrain,
I am sorry you are going thru this! I had SIBO- the same kind- i successful eradicated, however, from time to time I retest, usually with 3h long breath test just to make sure SIBO does not come back.
The most challenging part with SIBO is figuring out why is it there on the first place, looking for the cause if the key of successful treatment. Dr. M. Pimental (an expert i this space: http://bio.csmc.edu/view/3817/Mark-Pimentel.aspx) says 80% of cases is due poorly functioning migrating moto complex, the question is why is poorly functioning ?
Please let me know if you would like more details or resources.

P.S. I tried the diet- very limiting- I think is worth trying if you want to mitigate symptoms but I do not think the diet itself will eradicate SIBO (I might be wrong).

My best,
Magda

[TheBrain]

TheBrain, I’m sorry to hear that you have SIBO, but glad you were able to get an accurate diagnosis. I am definitely interested in hearing more about the testing you did, as I have unrelenting SIBO (classified as methane dominant). I have been trying to get rid of the overgrowth, which, in my case, is likely due to a motility problem, for years. Eating low FODMAP has reduced my symptoms, and I’ve also found Atrantil, which is designed to treat methane-dominant SIBO, to be quite helpful. But I still have flares whenever I eat anything that is even remotely fermentable. I wonder if sulfur could be an issue for me as well.

Thanks, LA18. I'm sorry to hear you have had SIBO for so long. It's great that you have found ways to reduce your symptoms but unfortunate that you still get flares when you eat fermentable food.

I did BioHealth's 3-hour breath test with lactulose. The pattern for hydrogen sulfide SIBO is pretty much a flatline across the whole test. My methane was literally at zero ppm. My hydrogen briefly peaked at 7 ppm on my 4th sample and then dropped to 3 ppm and stayed there for the rest of the test. The major sign is when the lactulose reaches the colon around 120 minutes into the breath collection process and there's no spike in either gas. That lack of a spike, when the lactulose should encounter lots of bacteria in the large intestine, indicates hydrogen sulfide SIBO. It could take longer than 120 minutes in people with a slow transit time, but the test goes for 180 minutes, so a peak should show up somewhere within that time period.

The hydrogen sulfide uses up the hydrogen from one or both gases: methane and hydrogen. That's why they flatline on the test.

I can ask my doctor if it's possible to have my type of SIBO plus one of the other ones. One common symptom that comes with my type of SIBO is flatulence that smells like rotten eggs. I don't have that, fortunately, but evidently most people do.

[TheBrain]

The end goal is to have a healthy gut and an expanded diet with at least some of my food sensitivities clearing once and for all.

Fingers and toes crossed for you to find the right treatment that works. You are so persistent and it pays off!

Thanks, Susan! One thing I can say about myself is that I persevere.

[TheBrain]

I am sorry you are going thru this! I had SIBO- the same kind- i successful eradicated, however, from time to time I retest, usually with 3h long breath test just to make sure SIBO does not come back.
The most challenging part with SIBO is figuring out why is it there on the first place, looking for the cause if the key of successful treatment. Dr. M. Pimental (an expert i this space: http://bio.csmc.edu/view/3817/Mark-Pimentel.aspx) says 80% of cases is due poorly functioning migrating moto complex, the question is why is poorly functioning ?
Please let me know if you would like more details or resources.

P.S. I tried the diet- very limiting- I think is worth trying if you want to mitigate symptoms but I do not think the diet itself will eradicate SIBO (I might be wrong).

Magda, it is inspiring to know you successfully eradicated the same type of SIBO I have! I'd very much like and appreciate more details and resources from you. Was your issue with your MMC?

I believe I have delayed gastric emptying, which causes early satiety. But things move slowly all the way to the end. I've heard of the MMC but don't know where it starts, meaning could that include the stomach or just the intestines?

This morning, I came across a great video titled Hydrogen Sulfide SIBO With Dr. Nigh. I need to watch it again with notebook in hand. Dr. Nigh looks at this type of SIBO as a sulfur metabolism issue. He does put people on a low sulphur diet, along with some supplements. One of them is Biotics Research, Mo-Zyme Forte, (Molybdenum). He said people with this type of SIBO are deficient in molybdenum, which is required for processing dietary sulfur into sulfate. (That's one of the supplements I'll be starting soon as part of my program.)

Dr. Nigh says the body overgrows the bacteria that produces hydrogen sulfide because the body can use the hydrogen sulfide as a backup if there isn't sufficient sulfate. However, there's a downside to hydrogen sulfide, i.e., all the symptoms that can result.

Dr. Nigh says that most people can re-introduce most foods than contain high levels of sulfur, but there's typically one or more foods that they need to avoid. The #1 offender in his clinical experience is garlic. Another big one is kale. I love garlic and kale! But I would willingly give them up for life to eradicate this SIBO.

[TheBrain]

Let me add that Dr. Nigh recommends that people with hydrogen sulfide SIBO take Epsom salt baths. Epsom salt is magnesium sulfate, which is the form of sulfur the body needs for many functions. He recommends using 4 cups of Epsom salt in hot water (as hot as one can tolerate because one's skin should be reddish, so it can better absorb the magnesium sulfate). Take this bath for 20 minutes, 14 days in a row. After that, only 2 or 3 times a week is necessary. The purpose of these baths is to increase the body's sulfate stores so it doesn't overgrow the bacteria that produces hydrogen sulfide gas.

I'm following the protocol that I'm being given at the virtual clinic; however, I'm adding in the Epsom salt baths.

Lastly, Dr. Nigh doesn't use herbal antibiotics (or pharmaceutical antibiotics). He finds that with his protocol he doesn't need to take extra steps to eradicate the overgrown bacteria that produce hydrogen sulfide.

Edit: Let me clarify that "magnesium sulfate" is not the form of sulfur the body needs. It's "sulfate." The magnesium sulfate in Epsom salt baths provides that sulfate.

[Magda]

Let me add that Dr. Nigh recommends that people with hydrogen sulfide SIBO take Epsom salt baths. Epsom salt is magnesium sulfate, which is the form of sulfur the body needs for many functions. He recommends using 4 cups of Epsom salt in hot water (as hot as one can tolerate because one's skin should be reddish, so it can better absorb the magnesium sulfate). Take this bath for 20 minutes, 14 days in a row. After that, only 2 or 3 times a week is necessary. The purpose of these baths is to increase the body's sulfate stores so it doesn't overgrow the bacteria that produces hydrogen sulfide gas.

I'm following the protocol that I'm being given at the virtual clinic; however, I'm adding in the Epsom salt baths.

Lastly, Dr. Nigh doesn't use herbal antibiotics (or pharmaceutical antibiotics). He finds that with his protocol he doesn't need to take extra steps to eradicate the overgrown bacteria that produce hydrogen sulfide.

Brain,
I apologies for the pause in communication. I had a super busy the end of a semester at school! A lot of studying!
How is your protocol going?

[TheBrain]

I apologies for the pause in communication. I had a super busy the end of a semester at school! A lot of studying!
How is your protocol going?

Hi Magda,

Glad to hear your semester is over. Are you "done done" or are more semesters coming?

The protocol is going fine. I'm in round 2 of the eradication phase, using herbal antibiotics, while following a low sulfur diet. It turns out I don't need to do low FODMAP. Which is good. Because food that is low sulfur is typically high FODMAP and visa versa. I'm also taking supplements for motility, HPA axis dysfunction, and insomnia. My sleep has been better, and as of last night, I'm starting to wean off one of my two sleep medications.

I've had to greatly reduce my Bredesen supplements for the duration of this program. I can't live on supplements alone; I'd simply be taking too many pills. I haven't noticed any obvious negative consequences.

Mindset is a big part of this program, and I hadn't really understood why until last week's Mindset call. My doctor says that people who get SIBO tend to live in a chronically stressful state, which impedes motility and digestion overall. Yes, that's me! So I'm going to go back over my homework and take it more seriously. And probably re-listen to some of the Mindset calls.

Are you back to eating high sulfur foods? Are there any you find you must avoid?