By Dr. Justin Marchegiani
Introduction to Resistant Starch
With resistant starch, we have two main kinds regarding our application.
The banana flour is great and is what I personally use because I have an autoimmune thyroid condition.
Potato flour is technically a nightshade, which can exacerbate some people’s autoimmune conditions. It’s the alpha-solanine component of the potato that tends to be the problem. If you’re autoimmune, try the banana flour or the plantain flour first.
I use both the potato and unripened banana flour, but I tend to feel better with the banana flour. I have some patients who do better with the potato flour, however, so I always recommend trying it out.
What Are the Benefits of Resistant Starch?
Let’s talk about the benefits. Again, the goal is to feed the beneficial bacteria in our small intestine. Many patients that I work with need a lower carbohydrate diet off the bat to help address and correct blood-sugar imbalances.
Typically, a lower-carbohydrate, higher-fat diet can be a great tool in helping to stabilize the blood sugar and helping to, essentially, take the stress off the adrenals/pancreas, stabilizing the up and down flows of blood sugar.
Going to a lower-carbohydrate, high-fat, moderate-protein diet can be a great option for many people. When we do that, some of the research shows that on a low-carbohydrate diet, we can lose some of our beneficial bacteria, especially the Roseburia and E. rectale species.
Adding some of the resistant starches mentioned above can help feed the beneficial bacteria by producing butyrate—butyric acid—the same fat as butter essentially. This helps to keep our small intestine more acidic and prevent SIBO, or small intestinal bacterial overgrowth, from coming up from the colon into the small intestine.
Some people may get a little bit constipated due to the shifts in bacteria on a low-carbohydrate diet. You can decrease the constipation by just upping the vegetables (nonresistant starch polysaccharides) and adding in the resistant starch in the two forms mentioned above.
What Do You Do?
Typically I start with about one teaspoon and work my way up to about two tablespoons. I continue to double my dose until the magic two-tablespoons dosage has been reached.
If you have an issue at all with the resistant starch, simply cut the dose in half until you find the correct dose for you.
If you have excessive gas, bloating, belching, or flatulence, cut the dose in half till you have no symptoms. If you have an issue with half a teaspoon, go to a quarter…an eighth…a sixteenth. Find that magic number.
Clinical pearl: Resistant starch can be used as a diagnostic tool to assess if you may potentially have SIBO (small intestinal bacterial overgrowth).
SIBO is when the bacteria from our colon, our large intestine, is moving back up to the small intestine. If you have too much bad bacteria there and you take a little bit of resistant starch—and, again, I recommend starting with a teaspoon—if you have any exacerbation of symptoms, like bloating or gas or bent-over pain or excessive flatulence, that’s a sign that you more than likely have SIBO. So this is a great tool to figure out if you have SIBO.
If you benefit with a low-FODMAP diet…and you can check out the Paleo dietitian, Aglaée, she has a great low-FODMAP Paleo diet. If you benefit from cutting out a lot of the FODMAPs, which are going to be your garlic, onions, broccoli, brussels sprouts, and cauliflower, by experiencing less gas and bloating, you more than likely have a SIBO.
SIBO can be diagnosed with expensive lab testing, which sometimes may be needed—but it can be diagnosed with resistant starch and a low-FODMAP diet as well.
Resistant Starch May Not Fix Your Gut
The goal of resistant starch is to act like a prebiotic, where it’s feeding the beneficial bacteria in your gut while increasing butyrate. The elevated levels of butyrate are also making the gut environment more inhospitable, which then makes the environment less hospitable. So what is this really doing? It’s creating a better environment for good bacteria to live in and a very inhospitable environment for bad bacteria to live in.
For some people with SIBO and other digestive issues, the cure-all is not going to be resistant starch or a low-FODMAP diet. You may need to get the right antimicrobials in there to help wipe out the infectious milieu residing in your GI tract.
Once the pathogens are removed, we can start to add back in some of the troublesome FODMAPs one at a time. You need to be careful of the FODMAP load. Having broccoli for lunch and asparagus and brussels sprouts for dinner may be enough to set you over the top.
When you start adding FODMAPs back into your diet, start with one new FODMAP per meal per day.
What To Do Next?
Are you are having chronic gut issues (leaky gut syndrome), fatigue, low thyroid symptoms, and weight gain?
If you are looking to get some answers, running some specific functional medicine tests may be the only way. Most chronic health issues tend to get worse over time if they are left untreated, and the conventional medical options tend to cause more problems in the long run.