Signs and Solution for Gut Inflammation and Leaky Gut | Podcast #351

In this video, Dr. J and Evan stress the importance of what you eat and how it impacts the rest of your body. However, what you might not realize is how your food is digested in your body, and when it gets inflamed and leaky, how do you fix it?

A lack of digestive enzymes can cause leaky gut syndrome—another unfortunate result of chronic inflammation in the digestive system. Many culprits cause leaky gut, including stress, medications, poor food choices or quality, alcohol, cigarettes, and even hormone changes.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
1:08  – Poor Gut Health Connection to Virus.
4:31  – What is the role of bile movement and production?
11:16 – The influence of gut michrobiota on Inflammation and Insulin Resistance
19:29 – General recommendations on carbohydrates and for a healthier gut


Dr. Justin Marchegiani: Hi! Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the signs and solutions of gut inflammation and gut permeability or leaky gut for short. Really exciting topic. We see it a lot in our patients every single day. Evan, how are we doing today man? 

Evan Brand: Hey. I’m doing really well. I can’t remember if we covered this on the podcast or not, this specific study but there was a paper that came out all about leaky gut and worsen outcomes with the virus and so people could put in the, you know, what virus in PubMed and leaky gut and we’re finding that a lot of people with leaky gut that’s actually one of the precursors and that’s what’s leading to worse outcomes so this is more important, It’s always important but this is more important now because we know that there’s a massive link and I’ll actually pull this up here and I’ll show you this, American Society for Microbiology, they did this. Did we talk about this yet or not? 

Dr. Justin Marchegiani: Let’s talk about it. Let’s go ahead. 

Evan Brand: This particular paper. Let’s bring it up there. 

Dr. Justin Marchegiani: Let me check here. Oh yeah. Let me add it on. Go ahead.

Evan Brand: Yeah. So, there we go. So, poor gut health is connected to severe blank, new research shows and long story short, you can go into this microbiology article but long story short they actually show a picture too. Let me see if I can get to that picture. Here we go. That was the picture. I think, we already showed this picture but forgive me and people listening on audio. Basically, we’re just showing that viral particles with a leaky gut are gonna be able to get into the circulation and that’s gonna increase your inflammatory response so the real goal of today is making sure that your gut is in good shape because therefore you’re not gonna have leakage into your circulation. You’re gonna be far far better if you have that healthy gut barrier. So, that was really kind of the spark notes of that but that’s like a 19 pages paper that you can dive into and many people I think have thought of leaky gut as kind of trendy topic that only people like you and I talk about but this is finally, actually getting into the mainstream. So, I hope gastroenterologists are gonna realize the importance of addressing the gut and I hope they actually start taking it more seriously. Right now, it’s just antibiotics that’s really the only thing that gastroenterologists do for gut, right? I mean steroids maybe and immune modulating drugs in the case of like, ulcerative colitis and Crohn’s but beyond that there’s not really much leaky gut conversation going on. 

Dr. Justin Marchegiani: No. There’s not and again, really, a leaky gut has an effect, right? Or we’ll call it gut permeability, right? If you go on PubMed, a leaky gut is like a slung. If you want to really find it, you want to look at, you know, gastrointestinal permeability, right? These are gonna be the big things, it’s the tight junctions, the epithelial cells and the small intestine, they start to come apart like my fingers here interlocked like I’m saying a prayer, they come apart and then you can see lipopolysaccharides undigested food particulate can slip out. So, this is, um, this is part of the major, major mechanism. Now, with gut permeability, it’s an effect not a cause so I always tell patients, we don’t go in and treat leaky gut, we treat the corresponding vectors of inflammation that drive gut permeability so that could be food allergens, that could be immune stressors like virus, parasites, small intestinal bacterial overgrowth, general dysbiosis, poor digestion, antibiotic exposure, creating rebound overgrowth, fungal overgrowth, you know, just poor digestion, lots of stress, increased sympathetic tone and adrenal stress, that’s shutting down the digestive system and making gut permeability more probable. So, these are the big vectors so we always wanna draw a line. What’s the root cause and what’s the effect and gut permeability is in the effect not necessarily a cause.  

Evan Brand: Yeah. I’ve seen a lot of, even advertisements now on social media for all these leaky gut healing formulas and that kind of stuff and it always has the word heal involved but you could take as much glutamine and whatever else you want. You could go into an elemental diet and all of that. It’s not gonna get rid of these big root causes and certainly for me, I tried some gut support but ultimately it was resolving my parasite infections. That was the most important thing for me and so, you can test for this. This is not an uncommon situation; you and I personally and clinically see parasites every single week. So, when you hear this idea of like, oh, it’s a third world country problem, you haven’t traveled to Mexico or anything like that. That’s just crap, I see it all the time and I had them and I was not out of the country and I had multiple parasite infections and then that affects your bowel flow, right? Can we talk about the bowel for a minute, what’s the role there, because you and I talked about how you have to have adequate bile to act as sort of a natural antimicrobial but how is this happening. What do you think are the big driving factors for why bile production is just not good? 

Dr. Justin Marchegiani: Well, first off, we look at the domino rally of digestion. The first thing that has to happen is good, nice aesthetic pH in the stomach. So, we need adequate HCl in the stomach, hydrochloric acid that lowers the pH and again, lower pH tends to have an antimicrobial effect, right? So, if we have to bring the pH down a little bit, that makes it harder for bugs to grow and that pH is also responsible for activating a lot of proteolytic enzymes in our stomach so if we have a good pH, we activate our enzymes, that starts the digestive cascade, we make it harder for bugs to grow and then once all that kind that mixed up food and enzymes and acids and all the stuff in our stomach is all mixed up. That’s called chyme, C-H-Y-M-E, that gets released into our small intestine, our pancreas then produces a bunch of bicarbonate to bring that pH back up to around neutral but that pH being nice and acidic, it triggers bicarbonate and then it also triggers cholecystokinin production, CCK, which then causes the gallbladder to contract so then you get a whole bunch of bile that comes out, you get a bunch of bicarbonate that comes out of the pancreas but then you’re also gonna get a bunch of lipase and proteolytic enzymes, trypsin, chymotrypsin lipase, lipolytic enzymes is coming out of the pancreas as well. So then, you bring the pH back up, you add the fat digestive enzymes, the proteolytic enzymes and then you also stimulate that bile production which then emulsifies that fat. Think of emulsification as you have a nice greasy pan where you cook some bacon on, right? Throw under water, you feel the fat on the pan, throw some dawn soap on there, it emulsifies it. It breaks that up so then you can get it all out the intestinal tract and be able to absorb it, carry on, mycells and be able to use it for lipid bilayer, hair, skin, nail, energy all that stuff. Prostaglandins. 

Evan Brand: Yeah. Well said. And though bile is produced by your liver but it’s stored in your gallbladder so people that have had their gallbladders removed which is a very common surgery, a lot of surgeons are very happy to remove gallbladders, I think in many cases, they may have been saved with fixing these other upstream issues but, well, once it’s gone, it’s gone. So, people listening that have no gallbladder, you have to take that into consideration. There was a study here in 2018, it was in the annals of gastroenterology, it found that poor bile flow can contribute to the development of inflammatory bowel disease. So, you’re really setting yourself up and find all the time with people clinically when they come in, they’ve had gallbladder removal, we see a lot of issues, we see massive bacterial overgrowth problems in these people and I think that’s partly due to not having enough bile being stored anymore like you and I have talked about it before, I think you said it was a 10x concentration in the gallbladder, is that right? 

Dr. Justin Marchegiani: 10 to 15x. Yeah. 

Evan Brand:  So, you’re missing out on that when you have just liver production, you don’t have that storage facility. I mean you have some but just nowhere near what you would have had if you had your gallbladder. So, please. Try to save your gallbladder. You got to fix these upstream infections because that’s gonna be and get off proton pump inhibitors with the help of your doctor if you can because we know that, that suppression of stomach acid is gonna lead to the overgrowth which then fuels these downstream issues to not happen the domino effect, it literally gets stopped or prevented by the PPIs.

Dr. Justin Marchegiani: 100%. And so, we need good, think of bile, it’s an emulsifier, it breaks down fat, it’s also an antimicrobial and so we create antimicrobial environments by having good, nice, low pH by having good enzyme and acid levels that also helps and then also by having good bile output and plus the longer that food sits there and rots and putrefies because we are not breaking it down into its constituent parts, right? Then it’s gonna create future petrification, fermentation, and rancidification. Essentially proteins and fats and carbs are rotting, right? Then you can get gas and bloating and that just creates this incredible breeding ground for bugs to grow. It’s like you can have this beautiful home that you take care of but if you leave the garbage in there like, a week too long it’s gonna get like, stinky and then you’re gonna get a whole bunch of bugs attracted to it, right? Same kind of thing in our microbiome so it’s really important that we stay on top of, you know, those good health practices.   

Evan Brand: Let’s hit the symptoms and signs and symptoms because people know most of the gut ones but there are some that you and I find clinically that maybe people wouldn’t think are a gut symptom, right? It might not manifest outside of that so we can cover the stuff like unusual color texture, smell, messy poops, you have floating stool. You have maybe alternating diarrhea, constipation, bloating, gut pain. But, what about like, skin issues and what about anxiety and depression and hormonal imbalances and brain fog. I mean, you and I have seen, we lost count how many times we’ve seen cases where we simply just fix the gut and all the sudden, this depression is lifted. I had one client named Miranda, who she had been depressed for, she said quote 20 plus years, all we did is do a gut protocol. I gave her no antidepressant herbs. We simply just did a gut protocol and when we did a six-week follow-up, she said her depression was 90% better and when she said 90% better, she didn’t even sound too excited and I said, are you realizing what you just said to me. You’ve been depressed for over 20 years and you’re 90% less depressed in six weeks of doing a gut protocol like do you realize how profound that is and she goes oh yeah, I guess that is amazing. Thank you. And, I think people, they get so used to feeling a certain way that when the clouds lift. They’re almost not even ready for it but depression, anxiety, I would put at the top of the list for mental health issues connected to these gut inflammation problems, I will tell you. And, you and I discussed this I remember calling you one-night years ago is probably like coming up on be six, seven years ago was like 2014, 2015 and I was like man, I’m having like a panic episode or something and this was when I was living down in Austin and it was H. pylori. It was driving that because as soon as I cleared the H. pylori, all those weird episodes of panic completely disappeared and I’ve seen that more than just the n equals one, me, I’ve seen it many, many times. So, if you have anxiety problems, you go to the psychiatrist. They’re not going to suggest you have gut infections but that’s something you need to be thinking about. 

Dr. Justin Marchegiani: 100%. Yep. 110% for sure. Anything else you want to add in that topic?   

Evan Brand: If you’ve got mental health issues, look in the gut maybe even look in the gut before you look in the brain. Now, obviously, we’re gonna be doing organic acid testing and other things to look at neurotransmitters so we’re gonna check out dopamine, serotonin. We’re gonna look at what’s called quinolinic acid so we can look for actual brain inflammation or brain toxicity related to gut infections like sometimes Clostridia, we’ll see will drive up the quinolinic acid markers but we still have to fix the gut. So, if you have a family member, they’re anxious, they’re depressed, they’re fatigued. We’ve seen a massive link between chronic fatigue and gut infection. So, there’s another big one that people may not recognize, the gastro doc may not suggest your chronic fatigue is from a gut infection but it certainly can be skin issues as well. My skin was a wreck years ago. I had major acne even though my diet was clean. It was my gut.  

Dr. Justin Marchegiani: Totally. I also wanna highlight one other kind of variable here. I think it’s really important. I’m gonna pull this on screen here. I think this is really interesting. So, an interesting abstract here and it’s looking at the influences on the gut microbiome on inflammation and insulin resistance so this is interesting because we talk about insulin resistance, right? Consuming too much carbohydrate and refined sugar. All carbohydrates get broken down typically into glucose, fructose or a combination of the two, right? And so, the more sugar that gets released into our bloodstream that gets broken down whether from refined sugar, sucrose which is fructose in glucose, high fructose corn syrup is fructose in glucose 55, 45 concentration and then of course we have starches which get primarily broken down into glucose and then we have fruit which is more on the fructose side. These things all have an impact on our blood sugar and the more insulin resistant we become, we, it drives inflammation. It’s hard to utilize these fuel resources and these fuel sources to get deposited in our fat because our muscles don’t have the ability to store it. our liver loses the ability to store it. We don’t have the activity level. We don’t have the mitochondria stimulation to burn it so we store it as fat. Now, this article is interesting. It talks about obesity as the main condition that’s correlated with the appearance of insulin resistance. Think of this as when your cells get numb to insulin. Now, this is on screen here. People that are looking if you’ve got mental health issues on the audio version, we’ll put the link below for the whole video. Whole bacteria, their byproducts and metabolites undergo increased translocation through the gut epithelium. Translocate, let me give you the translation on that. Here’s your gut. Leaky gut happens, right? Where it talks about gut permeability and things start to translocate meaning move from the inside of the gut back into the bloodstream, right? So, it translocates through the gut epithelium into circulation due to the degradation of tight junctions. This is a leaky gut, right? Here. And it increases intestinal permeability that culminates in inflammation and insulin resistance. So, what this says is the inflammation caused by gut permeability caused by gut permeability caused by lack of enzymes, bile, food allergens, all the gut microbiome issues can actually drive inflammation and insulin resistance. Now, it makes it harder for your mitochondria to generate fuel because you’re not able to get that fuel into your cell and you start to become more of a sugar burner. It’s very difficult to burn fat when you have high levels of insulin, Very, very difficult. So, several strategies focusing on modulation of the gut microbiome using antibiotics, again, we would use antimicrobial herbs, probiotics and probiotic fibers are being experimentally used to um, in order to reduce intestinal permeability, increase the production of short chain fatty acids. Guess what, things like butyric acid, medium chain triglycerides. Those are all very helpful. And again, this helps promote insulin sensitivity and counteracts the inflammation. So, really, really important here. This study, influence of gut microbiome on subclinical inflammation here and this is the 2000, see what’s the study, 2013 study so we’ve known this stuff out for a long time here that the gut microbiome plays a major role on your blood sugar, blood sugar handling and if you’re a diabetic or someone with insulin problems, you need to be looking at the gut. Yeah. look at the diet, look at, you know, getting your diet and your macros in order, make sure your food quality is good and then look at really getting the microbiome dialed in to really help. That could be a missing piece of the puzzle for people that have really changed their diet but not quite gotten the metabolic benefits of losing weight yet. 

Evan Brand: Wow. That’s a good point. You know, when I think back, when I had gut infections, my blood sugar was definitely not as good. I mean, 2 to 3 hours is as far as I could go without having to eat a meal. Now, I could fast all morning and not eat till 1 pm and I’m perfectly fine. I think there is an adrenal component too. I think I’m in a lot better place with that but I can tell you that certainly after mixing my gut, my blood sugar and blood stability is much better. So, I think you’re onto something with that paper and how people that even have gone paleo or animal based or keto. That still has issues with blood sugar regulation. That could be a sign of gut issues and I think even If diet dialed in in some cases what like you’re showing here, there could still be issues with the blood sugar. So, sometimes, it’s portrayed as like just fix your diet and everything else falls into place but you have to consider these other factors and also, I’ll throw in at the, you know, 11th hour here, mycotoxins, we know that mold toxins significantly affect the gut barrier and create a leaky gut. They damage the mitochondria, and we know that certain mycotoxins promote the overgrowth of bacteria like Clostridia and Candida. In fact, the lab will tell you that on paper, for example mycophenolic acid, it’s a very common mycotoxin that we see that comes from water damaged buildings. You breathe that in, that’ll then affect the gut and allow the overgrowth. So, if you’re just treating the antimicrobial herbs or fungal herbs and you’ve missed this giant mold exposure that can still affect the gut, still affect the brain and people won’t get fully better. So, that’s really the beauty of what we do is we try to work through all these puzzle pieces and help you because you could have this guy who says everything is gut and you go all the way down this gut rabbit hole and not get fully better or you go all the way down this insulin resistance rabbit hole and you still miss the smoking gun. You got the leaking dishwasher and your whole kitchen cabinetry. We had a woman in Texas last week, her dishwasher apparently leaking for years. Her entire kitchen has to be replaced now. She’s looking at 25k, just to replace her whole kitchen and she’s been to 10 doctors, 10 practitioners and nobody’s figured it out and I’m not trying to toot my own but I’ll just say I kept suspecting something because she said that she would always feel weird while she was washing dishes at her sink. She would get a little bit of a headache, feel a little bit sick to her stomach, said, ‘huh, is it possible that something’s leaking?’ and then boom brought in the remediator and they found it. There was a leaking dishwasher black mold everywhere.   

Dr. Justin Marchegiani: Yeah. Mold plays a major role in stressing out the immune system. It can create gut permeability within itself and then obviously drives the insulin problems. And also, people that eat this type of diet, I mean, it’s natural when you have microbiome issues to create a bunch of sugar because these foods are from an evolutionary standpoint, things that had a lot of sugar in it ended up having a lot of nutrients in it, right? Oh, a bunch of berries, some honey, right? And they were very rare in society. It was hard to find a lot of these things. Even fruit, you know, back then, tended to be a lot more sour and bitter and we’ve kind of hybridized and you know selectively grown fruits that tend to be sweeter and more, uh, and more plump and luscious now they taste. And so, we have sweeter fruits today and so it’s natural for people to want to crave all the crap that feeds the bad bugs because the bugs are producing chemicals to make you crave these foods. So, you have to be educated and understand that these foods, even though you’re craving them, you need to like not listen to those cravings sometimes and really shift your gut in it. If it shifts your macronutrients in a way to starve out some of these bugs, it can make a big difference.   

Evan Brand: Yeah. Well said. I mean, a lot of fruits hybridize now too as you mentioned to be sweeter, so like a strawberry. I’ve seen strawberries as big as my hand sometimes, like, ‘God’, you know wild strawberries, they’re tiny. I mean they’re like the size of a fingernail, if you’ve ever seen wild strawberries out in the yard, very tiny and definitely not anywhere as sweet as the other ones. So, when you hear people talk about fruit, like our modern fruit, like you said it’s not really, it’s more like candy with some, it’s like natural candy as opposed to the more ancient fruits so If I can find like some heirloom apples and that kind of stuff, I’m totally into it. 

Dr. Justin Marchegiani: Exactly. And you know, my general recommendation with carbohydrates, just make sure you earn it, make sure you’re not in a place where you’re inactive and try to get some activity because sugar goes three directions: gets stored in the liver and muscle, okay, so, if you’re working out, you’re always draining that muscle every day, you have a storage reservoir for it a little bit in the liver; It goes to fat or it stays in the bloodstream and gets burned up by the mitochondria essentially. It gets burnt up mitochondria-wise by the muscles etc. So, it’s gonna go either stored, burnt, you know, it’ll stay in the bloodstream but burnt up by the muscles of mitochondria or it gets converted to fat. So, if you’re doing things that allow you to utilize the glucose in that bloodstream, not as big of a deal, but that’s what you really have to look at what activity level is and you have to work with your functional medicine doctor about dialing in those macros and some people they need to starve out certain macros especially the fermentable carbohydrates and a lot of the inflammatory foods especially grains, legumes, dairy. Those things are really, can be, drive a lot of inflammation and that can keep your sympathetic nervous system and your immune system on high alert which just drains a lot of energy from you. Food allergens can make you fat and they can drain energy from you. Yeah. Seeds too. You know, I cut out almond seeds, nut seeds. Yep, even some eggs too for sure. 

Evan Brand: I cut out eggs for her while greens, I mean, some people are way overdoing it on the leafy greens. I can’t tell you the last time I ate a salad. I don’t really care. I don’t do leafy greens. I used to but, you know, I see way too many people doing these like kale smoothies. I had a lady doing like a pound of kale a day. Oxalates were off the chart. We know those affect the gut barrier too so there are downsides to plants. 

Dr. Justin Marchegiani: Yeah. I mean, it’s all about, you know, how you tolerate it, can you eat and feel good afterwards, how does your stool look? Do you see a bunch of undigested particulates? If so, you may want to work on just chewing your food up more. Taking some enzymes. See if that helps or sauteed it a little bit and see if that moves a needle. Again, there’s almost always a way, we can adjust things so it works but everyone’s a little different. 

Evan Brand: If you need further help, you can reach out to Dr. Justin at his website, justinhealth.com. Now, we do worldwide consultations, phone, facetime, skype, whatever it can connect to, we do it. Lab tests are sent around the world. It’s awesome we have distributors to work with. We can get these things to your door. We sign off on it and get you rolling so we can investigate and look deeper. So, justinhealth and then for me Evan Brand, it’s evanbrand.com. You can reach out and we’re both happy to help you. We love what we do. We’re very blessed for the opportunity to be in the trenches. We’re always improving our own health. We work on our families, our children. We work on everybody around us. We’re always trying to improve them and to be able to do it clinically too is just great. We learn so much from you all and we like to be the shining light in a world of darkness where people have been to countless practitioners and the stuff that to you and I is just common everyday conversation, functional medicine stuff. This stuff to some people is like wow why has nobody ever mentioned that to me before. And for us, it’s like, oh yeah uh-uh, we do it with everyone. So, we look forward to helping you uncover your root causes if you have gut inflammation, what’s going on. There’s something under it so don’t give up, keep pushing forward and please reach out if you need help. We’d love to help you.  

Dr. Justin Marchegiani: Yeah. Evanbrand.com, work at Evan. Dr. J, justinhealth.com, works with me. We are here with you guys. And, put your comments down below. Let us know the different things that you guys are applying, what’s working, what’s not and if you get overwhelmed listening to this. Try to take at least one action item out of it. I would say action items from a supplement standpoint. We’ll put our recommended supplements down below. We have different hydrochloric acid and enzyme support products that we’ll put down below for links. That’s always low hanging fruit. Again, diet wise, you know, a good autoimmune, lower fodmap diet can really be a good starting point and I would say for liver gallbladder, you know, we have our different formulas. I have one called liver supreme and again some of the hallmark nutrients in these products are gonna be bile, phosphatidylcholine, taurine, some products will have things like Tudca, which can be very helpful for biliary flow. Beetroot can be really helpful. if I didn’t mention Ox Biles. These are all maybe some milk thistle, very supportive for liver, gallbladder function, liver-gallbladder flow. So, very beneficial, we’ll put the links down below so if you guys enjoy the information and you wanna take action feel free to take a look at some of those links and support the show by grabbing some of those products and Evan will have his links down below as well. Anything else, Evan, you wanna add?

Evan Brand: I think, I said, we give people the links. Make sure you subscribe to the podcast if you’re listening on apple that’s probably where most people find us if you’re looking up. Justin’s show, make sure you subscribe there or my show, Evan Brand. We don’t care how you’re listening, you know, obviously we cross pollinate. We put these on each other so make sure you’re subscribed to both of them so you don’t miss it and we appreciate it. give us a review too. I think we should probably do a giveaway. I know some people giveaways so we can give away a book or you know free supplement or something but, in the meantime, give us a five star review on apple, we would love it. That’s how we stay up in the rankings so that we can actually share true functional medicine education to the masses because right now there’s still a lot of people that are in the top charts just theory. They’re not clinicians. They’re not in the trenches every day, all day, I mean we look at an exhaustive amount of lab testing that helps us to really dial the stuff we’re saying in. We then sprinkle in some studies and we stay up on the research but you could keep your head in the research all day and totally miss what actually works and it’s all about what actually gets people the results. So, keep that in mind and make sure you subscribe. Give us a review on Apple, we’ll love you forever. Thank you. 

Dr. Justin Marchegiani: 110% All the links will be below for you guys. Alright, thanks a lot. Evan, great chat with you man. Have a good one. Bye everyone.  

Evan Brand: You too, take it easy. Bye-bye. 


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/signs-and-solution-for-gut-inflammation-and-leaky-gut-podcast-351

Recommended products:

Enzyme Synergy

TRUCOLLAGEN

Liver Supreme

Digest Synergy

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Genova NutErval

How to Treat Gut Infections: Antibiotics or Natural Herbs?

By Dr. Justin Marchegiani

Gut infections are common, and they can prohibit healing and cause a leaky gut. They must be treated to keep the body healthy, but are antibiotics the right choice for you? For some serious infections, antibiotics might be a good choice, but there are deleterious side effects.

herbal antibiotics

Let’s explore why antibiotics have side effects; why antimicrobial, or natural, medicines may be a better choice. And also, what the benefits are of natural medicines.

Antibiotics Pros & Cons

Antibiotics are one of the true miracles of the twentieth century. The invention of penicillin and other antibiotics over the last 50-75 years have saved thousands if not millions of lives!

We live in a world today where antibiotics are handed out like candy, and as a result our gut biome and our health are finally paying for it. Most conventionally trained physicians are still not recommending a round of probiotics after an antibiotic treatment. In my professional opinion, this is an absolute must if antibiotics are ever to be used.

There is a phenomenon known as antibiotics resistance where we are creating superbugs from excessive antibiotic use. I saw a patient just last week who over a 10-year period was given over 100 prescriptions!

This excess antibiotic use causes rebound overgrowth in the digestive tract, essentially causing the bad or sometimes pathogenic bacteria to proliferate. As a result, it will take up most of the space in our GI tract.

antibiotic resistance

If you use the garden analogy for our gut bacteria, everyone knows it takes virtually no effort for weeds to grow, yet, it takes good eating habits, stress reduction, and sometimes supplements to keep the good bacteria predominating. In the garden analogy, the healthy plants or vegetables growing.

When to take Antibiotics?

The bad bacteria in our gut can produce toxins and make it harder for us to absorb nutrients from food. In acute serious infections, antibiotics may be the right choice. With these chronic everyday situations, herbal medicines have a longer and safer track record and tend to be more selective to the bad bugs without causing as many side effects.

I was in a serious situation this last summer with a hand infection from a cat scratch and I was very close to using an antibiotic to treat the infection. I actually had the prescription in my possession, yet after 3 days of natural herbs, the infection resolved. If the infection hadn’t started resolving so soon, I would have had no hesitation to use the prescribed antibiotic.

What Are Efflux Pumps?

Bacteria or infections have a phenomenon known as efflux pumps. The antibiotic enters the cell, where it is metabolized. The efflux pumps then force the antibiotic out of the cell and into the extracellular space or back into the gut.

Imagine you’re in a canoe on a river, and the canoe has a hole in it. The canoe starts taking in water. Your natural response would be to grab a bucket and start bailing water from the canoe.

Efflux pumps are very similar to the bucket. The bucket takes the water that shouldn’t be in the canoe and bails it back into the river.

The same thing happens with the bacteria. That bacteria wants to thrive, and it knows the antibiotic isn’t good for it, so it takes the antibiotic. Just like you’d bail water from your canoe, the bacterial will shoot it’s way back into the intestinal track where it thinks it belongs.

efflux pumps

Our goal, however, is to kill the bacteria, so we must inhibit the efflux pumps. If we inhibit the efflux pumps, the bacteria will retain the drug or the antimicrobial, which will procure its demise. If the canoe is analogous to the bacteria, we want the canoe to take on water faster. So knocking out the person with the bucket (the analogous efflux pump) is the goal.

Do you think you have an infection, click here!

How Can We Block the Efflux Pump?

When we create protocols to knock out these infections, how to block the efflux pump is the question that is first and foremost in mind. There is a family of herbs called berberines, and it includes the following:

• Goldenseal
• Oregon grape
• Barberry

These herbs have efflux-inhibiting properties. They have been used in cancer medications, infection-treatment plans, and other treatments. They actually block the function of the efflux pumps.

If you’re going to use an antibiotic, at least use it with a gram of goldenseal to block the efflux pump. This will prevent the bacteria from shooting the antibiotic back out into the extracellular space or the gut.

However, a better choice, which may give a far superior result, could be to take a combination of berberines and other herbs. This is especially effective if you are in relatively good health and making good dietary changes. This healthier lifestyle will boost the immune system, giving you a better chance of responding to the herbs.

dysbiosis

What Are Natural Ways to Address Gut Infections?

  •  Local killer: Goldenseal is one local killer that will target the area of the infection.
  •  Systemic killer: Artemisia or wormwood are systemic killers that will get in the blood and target the whole system.
  • Infection-specific killer: Herbal cocktails are created specifically to fight a certain infection. If you have a virus, we may use silver; If you have a Lyme disease coinfection, we may use neem or noni; And if you have a gut-bacteria issue, we may use oil of oregano.

There is an excellent synergistic effect when combining local and systemic killers—wormwood and Artemisia combined with goldenseal. The goldenseal makes the Artemisia stronger.

The Viscous Cycle of Infections:

Most people with a chronic unaddressed infection are kept trapped in a viscous cycle of a weakened immune system, nutrient malabsorption, and a leaky gut.

Our body needs nutrients to run its energy systems, and we derive those nutrients primarily from food. With a chronic leaky gut due to infections, we are assured to develop food allergens to even so-called healthy foods, like broccoli and beef. Thus, our diet becomes more restrictive as the root cause to many of these gut issues gets commonly missed.

With the additional stress to our digestive system, we also lose the ability to make adequate levels of enzymes and HCL. These compounds help break our food down, but they also help kill potential foreign invaders in our food, like bacteria and parasites.

As you can see, it’s common for people, over the years, to collect their gut infections like souvenirs on their mantle. The more gut bugs or infections you have, typically the longer it takes to recover.

If you want to break the viscous cycle of gut infections, click here!

gut infections cycle

Conclusion

Efflux pumps are the real problem, and that’s why a lot of antibiotics have side effects. The protocol for most antibiotics is only about 10–14 days. With a natural antimicrobial program, the protocol can be 60–90 days, allowing us to slowly break down the whole efflux pump system.

Natural programs include using specific herbs, like the goldenseal, and utilizing the synergistic effect of stacking local, systemic, and infection-specific herbs.

Use Mother Nature’s natural herbs first and foremost. Antibiotics can be beneficial when used in combination with the appropriate natural herbs, but antibiotics should be the last-resort approach.

If you have a gut infection, tough-to-remove parasite, H.pylori infection, or viral infection, these are common blocks that keep you from healing and cause a leaky gut. If you need more help to eliminate these gut infections, click here.

The Good, Bad, and the Ugly of Your Gut Bacteria

By Dr. Justin Marchegiani

Did you know that the bacteria in your gut has a huge effect on your immune system? Your gut houses 70% of your immune system. Gut-associated lymphoid tissue (GALT) and mucosa-associated lymphoid tissue (MALT) reside in the gastrointestinal tract, and these lymphoid tissues produce antibodies that fight bacteria, viruses, parasites, and infections.

If you don’t have a healthy gut balance, your immune system will be severely affected. There are three main types of bacteria that determine the health of the gut: beneficial, commensal, and pathogenic.

3 Main Types of Bacteria Involved in Gut Health

Beneficial Bacteria

Beneficial bacteria include probiotics, such as Lactobacillus and soil-based probiotics. They aid in the following:

  • Nutrient Breakdown
  • Energy
  • Immune Function
  • Detoxification

gut bacteria

You need certain nutrients and absorption of these nutrients to help run your detoxification pathways. If you don’t have beneficial bacteria, you can produce enzymes known as beta-glucoronidases that can negatively affect how bile conjugates hormones. Beta-glucoronidase and good bacteria levels are an inverse relationship. If you have high beneficial bacteria levels, you’re going to have low beta-glucoronidase.

The good bacteria in your gut also produce acids, like lactic acid or CO2, that can lower the pH. When the pH in your gut is lower, it’s harder for bacteria that are bad, or pathogenic, to proliferate. Yeast infections proliferate more in an alkaline urinary tract than in an acidic urinary tract. That’s why things like cranberry extract and resistant starches can be beneficial. Resistant starches feed butyrate (butyric acid), which helps decrease microbes.

You need healthy hydrochloric acid (HCl) levels in your stomach. Without it,  you can’t break down proteins, start protein metabolism, or ionize minerals. If you can’t ionize minerals, you can’t absorb minerals. Protein digestion starts in the stomach, so the first domino falls over in the stomach. If that domino doesn’t fall, then the dominoes in the gallbladder, where fat is emulsified, and pancreas, where lipase and other enzymes and fats are produced, won’t fall. So beneficial bacteria is very important for helping the first domino of digestion fall.

Commensal Bacteria

Commensal bacteria are switch-hitters that can become either beneficial or pathogenic. Stressors, the factors shared later in this post, can push them to one side or the other.

benefits of gut bacteria

Symptoms of Bad Bacteria Levels

If you have any of the following symptoms, there is good chance that your bacteria levels in your gut are tipped more toward the pathogenic side. Unless changes with diet, gut bacteria, infections, and stress are changed, symptoms tend to get worse over time!

  1. Bloating
  2. Gas
  3. GERD or acid reflux
  4. Constipation or not having a bowel movement at least once per day
  5. Diarrhea
  6. Stomach pain
  7. Any active gut infection

Pathogenic Bacteria

Pathogenic bacteria include bacterial infections (e.g., H.pylori), parasites (e.g., C.difficile), and infections. They can produce the following:

  • Toxins

    These toxins include mycotoxins, endotoxins, or various biotoxins produced by infections. These infections disrupt peristalsis, which can cause bowel movements to take longer and can cause the body to reabsorb a lot of toxins from the bowel, resulting to autointoxication.

  • Malabsorption

    If you’re not able to absorb certain nutrients and minerals, it’s going to have an effect on your energy systems, the Krebs cycle, and the electron transport chain. You must have nutrition to run your energy pathways.

  • Leaky gut

    Leaky gut drives autoimmune conditions. In a leaky gut, the tight junctions in our bowel start to open up, forming various cracks and allowing food molecules and bacterial infections to slip into the bloodstream. The immune system creates a hate response to these foreign molecules, and because a gluten molecule may look similar to the thyroid tissue or a dairy molecule may look similar to the pancreas, other tissues start to get destroyed by mistaken identity.

If you think your gut bacteria is out of balance, click here.

Factors That Push “Gut Bacteria”

There are many factors that push gut bacteria in one direction or the other. All of these tend to be opportunistic, which means we start to see a decrease in HCl, enzymes, and nutrition. You aren’t what you eat; you are what you eat, break down, absorb, and assimilate.

The following factors push us in the direction of the pathogenic bacteria:

  • Medications

    Proton pump inhibitors (PPI), such as Nexium and Prilosec, shut down HCl production, but HCl production is important for the first domino of digestion. When acidity is low, HCl will trigger the esophageal sphincter to close. If it doesn’t close, it’s very easy for the acids to rise up, burning the throat and creating a reflux disorder. Acid breaks down nutrients, and if you don’t get good breakdown, it creates a downward cycle that only gets worse. A good doctor can find the root cause of the issue and pull you off a PPI responsibly. Don’t randomly take yourself off it.

  • Sugar

    If you’re eating too much refined and processed sugar, it feeds the bad bacteria in your gut. About one hundred years ago, each person was consuming and average of 3–4 pounds of sugar per year; now it’s about 150 pounds. Too much sugar consumption feeds the funguses and pathogenic bacteria in your gut.

  • Emotional

    Emotional stress will increase interleukin 6 (IL-6), which is an immune compound that can throw your immune system out of balance. Your immune system and gut are intimately connected, and you should minimize emotional stress to have a healthy gut balance.

  • Decreased probiotics

    Maybe you’re not eating probiotics via fermented foods, like raw milk if you can tolerate dairy. Get natural probiotics from foods you can tolerate.

  • Increased antibiotics

    The consumption of antibiotics wipes out everything in the gut and causes rebound overgrowths to occur. If you wipe out everything in a garden, the first thing that grows back, unless you plant seeds, is weeds. If antibiotic use is an issue, you need to consume good seeds (prebiotics and probiotics) for balance.

  • Infections

    Infections tend to be opportunistic, which means they happen when someone already has a compromised immunity. A tick bite causing Lyme disease can drive one person into a pathogenic episode while another can be bitten and recover quickly. Everyone is a little different, but the more stressors a person has, the more complicated the infection can be. Those who bounce back quickly may be feeding, and have a greater abundance of, the beneficial bacteria in their gut. An infection can prevent healing even when these stressors are removed, and the infection may need to be addressed for you to fully heal. Some patients can get exposed to a parasite, like Giardia, or pathogenic bacteria, like H.pylori, and not recover from the infection and get sick.

  • Leaky gut

    Foods and unwanted bacteria in the intestinal track can slip through the tight junctions into the bloodstream. This can put stress on the immune system and is the main cause of autoimmune disease for most people.

leaky gut issues

Most people who have a digestive problem seem to have a higher amount of bad bacteria as well as a potential active gut infection. These problems tend to be active for many years before symptoms start to even show. Getting the gut fixed is one of the most important codes to crack for any functional-medicine doctor trying to get his or her patient healthy again.

If you need help balancing your digestion, feel free to click here.

Leaky Gut Syndrome and the Autoimmune Disease Connection

By Dr. Justin Marchegiani

Leaky gut syndrome (gastrointestinal permeability) is a phenomenon that occurs within the intestinal tract where the epithelium tissue’s tight junctions open slightly, allowing undigested food particles and potential bacteria (endotoxin) to make its way into the bloodstream. These compounds are typically only found in the gut, so our immune system goes on high alert when it starts seeing new and unusual things. Our immune system reacts by creating various immune cells called antibodies to inspect what’s going on (and potentially attack)! These antibodies are equivalent to our navy, marine corps, air force, and army; their job is to tag these various particles for destruction. When our immune system attacks some of these foreign proteins (antigens), various organs can get caught up in the scuffle. This accidental tagging is a case of mistaken identity, or the scientific term molecular mimicry.
leaky gut and inflammation

How Does Molecular Mimicry Work? 

There are amino acid sequences on these antigens (foreign particles) that are similar to other tissues in the body. Our immune system reads these antigens by the sequence of its surface proteins. It’s kind of like getting pulled over by a policeman that is out looking for a similar make and model of the car you drive because a suspected criminal was seen driving the same car earlier that day. Foods like gluten can easily cause your immune system to start attacking the thyroid gland, brain, intestinal tract (celiac, Crohn’s, ulcerative colitis), or other nervous-system tissue based on similarity and genetic predisposition. There’s a good deal of research showing that autoimmune disease cannot occur without a leaky gut. This is why people with a chronic illness need to have their gut checked. Click here to get your gut checked!

Gluten and Cross-Reactivity

When these proteins have a similar shape to other proteins, cross-reactivity can occur. These proteins have the ability to bind into other receptor sites, just like with casein and gluten. As you can see by the picture below, the shape of the antigen can be enough to confuse the immune system.

cross reactivity

Foods containing things like casein from dairy products can cause the immune system to start attacking the pancreas. Casein can also cross-react with gluten too! Cross-reaction is where the immune system starts responding to other proteins as if they are gluten. This is the reason why some people who only remove some grains from their diet may not recover fully. The consumption of other cross-reactive foods outside of gluten can be enough to prevent your thyroid from healing.

It All Comes Down to Genetics

Wherever the weak link in your genetic chain is, may be the deciding factor regarding what autoimmune condition you express. The tighter you pull your genetic chain, the increased chance those weak links will be exposed and break. The tightness is equivalent to the stress in your life, while the weak link is symbolic of your genetic susceptibility.

genetic predisposition

Some people may get Hashimoto’s (autoimmune thyroid condition) while others may develop multiple sclerosis or Parkinson’s disease. There tends to be a genetic link regarding what condition you may express. If Parkinson’s or Hashimoto’s runs in your family, this may be a good indicator of what you are predisposed for.

Genetic predisposition is not a death sentence but merely a strong warning you need to heed. I personally have an autoimmune thyroid condition and also have many other autoimmune conditions that run in my family. Because of this, I pay close attention to my diet, emotional stress, physical stress, and chemical stress. The stressors, or allostatic load, in your life have a huge impact on your epigenetics. Your epigenetics control what genes your body expresses, kind of like turning a light switch on or off. So in other words, you have the ability to control what genes you express or don’t express.

So if you have a predisposition toward chronic degenerative autoimmune conditions, it’s really important that you develop other healthy habits that keep those genes from expressing themselves. The more our immune system is fired up, the more inflammation occurs in our body. The additional inflammation and undigested food proteins put additional stress on our detoxification system, causing our liver to have to work harder to filter out all those extra antigens and toxins in our blood stream.

What Causes Leaky Gut?

Inflammation is the underlying cause of leaky gut. Below I will talk more specifically about what the underlying drivers of inflammation are.

dysbiosis

Food allergens

All grains, especially gluten-containing grains, such as wheat, barley, rye, oats, spelt, and Kamut, can be hyperallergenic. Other foods can also cross-react with gluten, such as dairy products (especially milk products that are higher in casein) and legumes (soy, beans, and peanuts). Butter, heavy whipping cream, and ghee tend to be OK. Some people who are autoimmune need to avoid everything but ghee. Many of these allergens tend to be a little controversial.

Most people think of allergies as the kinds that close up your throat, like when someone who has a peanut allergy eats peanuts. That type of allergy is known as an IgE-mediated immune response, or in the above peanut example, an anaphylactic response. We tend to know about these allergens in childhood because of some type of traumatic experience that may have included a blocked airway, itching, and/or hives. The allergenic response I am talking about comes from a different part of the immune system. Essentially, a low-grade inflammation that occurs because of a cross-reactivity or an IgA–, an IgG–, or a T-cell–mediated immune response. These types of immune responses can cause leaky gut and contribute to thyroid imbalances, adrenal fatigue, brain fog, weight gain, and other digestive symptoms.

Low stomach acid

We need HCl, or stomach acid, to help break down our proteins and ionize minerals. If we don’t have enough stomach acid, we can’t break down and absorb zinc. If we don’t have enough zinc, this can affect our immune system, sex hormones, and our ability to make stomach acid. As you can see, a downward spiral is occurring that causes our body to break down even faster with no end in sight!

Infections

With inadequate stomach acid, we are also prone to gut infections (bacterial, parasitic, fungal, and viral) and small intestinal bacterial overgrowth (SIBO). Many of these infections produce biotoxins/endotoxins that can affect hormone metabolism and nutrient absorption and can contribute to fatigue of the thyroid and adrenal glands. Chronic infections tend to play a role with autoimmune conditions as well as leaky gut.

How Do We Fix Leaky Gut?

When getting to the bottom of leaky gut, it’s essential to incorporate a 5R program (remove, replace, repair, remove, and reinoculate). Just like baking a cake, the order in which things are done is very important to making the recipe tasting great. Just like when addressing chronic leaky gut autoimmune conditions, the order and how we address the underlying cause is important to preventing relapse as well as to feeling as good as you possibly can during the process. Again, I want to stress that it’s very important to address underlying hormonal imbalances, including adrenal, thyroid, and female hormone issues, before getting to the chronic infection.

I personally find that patients will fall apart during the treatment if this isn’t done. This is dependent on how long the person is sick and how sick the person is, and there are exceptions to every rule. If the person’s hormonal system is not supported adequately when removing the infection, the chance of a die-off reaction is higher. Die-off reactions may feel something like fatigue, headache, nausea, and/or chills. Some people may notice nothing when the infection is being removed while others may have significant die-off reaction symptoms. There are various techniques and herbal medicines that can mitigate die-off or Herxheimer reactions.

The 5R program follows:

Remove

This part’s pretty simple. Remove the foods that are creating inflammation. Some people may need to be on a stricter autoimmune Paleo type of diet. Some may need to remove FODMAPs (a group of carbohydrates the small intestine has trouble absorbing). For others, a clean Paleo diet may be enough. An elimination provocation diet is the easiest way to be specific and avoid expensive and sometimes unnecessary allergy testing.

Replace

People with chronic stress can have low stomach acid. When there’s low stomach acid, there is typically low enzyme and bile salt production as well. It’s always good to work up to a patient’s stomach-acid tolerance so we can ensure the patient is breaking down proteins, fats, and minerals optimally. We need to make sure the building blocks are present, broken down, and absorbed so the person can heal.

Repair

Depending on how stressed or inflamed a patient is, adding additional healing and/or soothing nutrients can be helpful. Sometimes just making the above changes is enough to help facilitate healing. Others may need additional compounds, such as L-glutamine, slippery elm, zinc, aloe vera, and deglycerized licorice.

Remove

This is the place where we remove the infection. As you can see, the infection is one of the last things we address. This helps prevent die-off reactions from overwhelming the detoxification system, immune system, and lymphatic system. I find that removing the infection at the end tends to be the most effective.

Reinoculate

This is where we add the probiotics back in. Many people have a dysbiosis (or SIBO) in the gastrointestinal tract. This is when there is an overwhelming amount of bad bacteria in relationship to good bacteria. Adding in probiotics when there is a high amount of bad bacteria can cause problems, such as gas, bloating, and gastrointestinal pain. Removing the infections and bad bacteria first, allows the good bacteria to flourish. The analogy is weeding the garden before you plant the seeds—you never put seeds into a garden full of weeds.

Hidden barriers

Chronic infections can encase themselves in the slime known as biofilms. These biofilms are resistant to antibiotics; therefore, the conventional approach to treating these infections tends to not be as successful. Working with a skilled functional-medicine doctor that can combine the right antimicrobial herbs for your infection with some well-known biofilm busters is an important ingredient to removing the infection in the long run.

What Should I Do Next?

If you’re suffering from an autoimmune condition, fatigue, digestive problems, and/or hormonal imbalances, there is a good chance that leaky gut is playing a part. If you want to take a closer look into what’s causing your health issues, feel free to click here for a complimentary consultation.

Solutions to Small Intestinal Bacterial Overgrowth (SIBO)

By Dr. Justin Marchegiani

I see patients every day walking to my clinic with small intestinal bacterial overgrowth (SIBO) symptoms. Have you ever felt your stomach pooch out after eating certain foods? Do you ever feel like you can’t quite digest your food all the way? Small intestinal bacterial overgrowth can also contribute to leaky gut syndrome!

There are millions of people with SIBO-like symptoms covering them up with medications that don’t fix the underlying problem. SIBO can affect our immune system and compromise our body’s ability to break down food and absorb nutrition.

gut health

Below are 5 signs you may have SIBO:

1. Burping or belching

2. Flatulence

3. Indigestion/low nutrient absorption (low B12, proteins, and fats)

4. Diarrhea or constipation

5. Abdominal pain

SIBO causes

What Causes SIBO?

1. A lack of stomach acid

When we have low stomach acid, or achlorhydria, our body lacks the ability to activate protein-digesting enzymes in our stomach, called pepsin. We need a low pH (acidic), right around 2, to ensure our body’s optimal digestive capabilities. This is why people on proton-pump inhibitors (drugs that block stomach acid) are at an increased risk for SIBO.

A low pH also provides an inhospitable environment for bad bacteria to grow. When bad bacteria overpopulate the stomach, it’s easy to see the increase in intra-abdominal pressure. This increase in intra-abdominal pressure can open up the esophageal sphincter and allow acids from the stomach to rise up and create irritation or burn the esophageal tissue. Without adequate levels of stomach acid, SIBO is almost certain!

2. Pancreatic insufficiency

Without adequate enzyme production, our body has a difficult time digesting proteins and fats. When our body doesn’t break down these proteins and fats fully, they putrefy, rancidify, and ferment in our intestinal track. This is not good!

HCl is the first important step for enzyme production. Without an acidic pH, the foods that are released from our stomach into our small intestine will not provide enough stimulation to trigger the gallbladder to release bile acids and pancreas to produce protein (trypsin and lipase) and fat-digesting enzymes. Without the crucial release of these enzymes, our body is at an increased risk for small intestinal bacterial overgrowth, or SIBO.

3. Chronic infections

Many infections are opportunistic and are able to take hold of the person’s body because of an accumulation of physical, chemical, and emotional stress. When this happens, we tend to have a decrease in immunoglobulin A (IgA). IgA is a protective mucous membrane barrier that lines our intestinal tract and plays an important role at preventing SIBO. Because 70 to 80% of our immune system is located in the lymphoid tissue in our intestinal tract, this has the ability to throw our immune system out of balance.

Chronic infections can lower stomach acid and decrease our body’s ability to break food down. With low IgA and a lack of stomach acid, our body is a sitting duck for an infection. Bacterial and parasitic infections are known to produce toxins (endotoxin and lithocolic acid) that can actually suppress our immune system. If you’re having chronic SIBO-like symptoms, feel free to click here to see if an infection connection is possible.

Other predisposing factors for SIBO

There are many other risk factors for SIBO, including fibromyalgia and IBS. These other conditions have common threads along with the main causes of SIBO that are above.

When our immune system is compromised by various infections, we have an inability to break down, absorb, and assimilate food due to an increase in physical, chemical, and emotional stress. This accumulation of stress eventually breaks the weak link in your chain. Because the gut is so central to the immune system, so many different conditions have a common link with small intestinal bacterial overgrowth. I would go as far to say that it is impossible to have a chronic disease without some type of gut dysfunction!

What Is SIBO?

SIBO is typically caused by a migration of bacteria from the large intestine making its way back upstream into the small intestine.

“SIBO may be accompanied by both maldigestion and malabsorption. Bacteria in SIBO might significantly interfere with enzymatic, absorptive and metabolic actions of a macro-organism.”

When our digestive system becomes stressed, our ileocecal valve can become loose. The slack in the ileocecal valve makes it easier for bacteria to migrate up the gastrointestinal tract. If more bacteria starts making its way up the GI tract, it makes it harder for the healthy gut bacteria in our small intestine to produce important nutrients, like vitamin K, vitamin D, iron, and various B vitamins.

What Type of Bacteria Is Found in SIBO?

Streptococcus 60%, Escherichia coli 36%, Staphylococcus 13%, Klebsiella 11% and others, as well as 117 anaerobes (Bacteroides 39%, Lactobacillus 25%, Clostridium 20%, and others) are found in SIBO.

How Do You Test for SIBO?

1. Hydrogen or methane breath test

A solution of glucose or lactulose is consumed. Hydrogen or methane levels are measured after the test, and if hydrogen or methane is found in amounts greater than or equal to 20 ppm, it is considered a positive test for SIBO. Ammonia is a common by-product from the intestinal bacteria. Ammonia has a pH of 11, so it’s easy to see how bacteria can affect intestinal pH!

2. Comprehensive stool test

The pathogenic bacteria mentioned above can be found in the stool by a comprehensive stool analysis. All lab companies are not created equal when it comes to this type of specialized testing. I recommend only using the best companies to ensure that you are getting accurate results. My three favorite lab companies for stool testing are Biohealth Diagnostics, Genova Diagnostics, and Doctors Data. If you are trying to get assessed for SIBO or any other infection, feel free to click here!

3. Organic acid test: This test can look for metabolic by-products of SIBO, including benzoate, hippurate, phenylacetate, phenylpropionate, p-hydroxybenzoate, p-hydroxyphenylacetate, indican, tricarballylate.

How do you treat SIBO?

Conventional Treatment Options

Conventional treatments typically consist of taking specific antibiotics, such as metronidazole and rifaximin. Antibiotics are powerful medicines, and I typically recommend a natural herbal approach first. The herbs tend to be more gentle on the body and don’t have all of the side effects.

Natural Treatment Options

There are many herbal medicines that can help eradicate SIBO. One of my favorites is oil of oregano. Other great herbs include berberine, artemisia, cat’s claw, colloidal silver, and ginger.

Sometimes it’s more than just SIBO causing the problem. If you are having any of the above symptoms, it’s good to get checked by a functional-medicine doctor to make sure there are no other infections driving the problem.

Some of these bacteria use biofilms as a means to protect themselves from the antimicrobials. It can get a little more nuanced when addressing the stubborn infections. Feel free to click here if you need help!

I find many patients do better at making diet and lifestyle changes first and addressing the adrenals and hormonal system second before addressing the gastrointestinal system. When patients go right to the GI system, the side effects tend to be much higher!

Dietary Interventions

FODMAPs: Removing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) from the diet is also important. These FODMAP sugars can fuel the pathogenic bacteria in the gut, which then leads to more toxic metabolic by-products. Many people notice great improvements in stomach distention, gas, and flatulence after removing these foods from the diet. I personally find a combination of diet, lifestyle, and herbal medicines tend to be the trick to addressing the underlying cause of the problem.

Resistant starch: Adding resistant starch type 2 or 3 into your diet can also help feed the beneficial bacteria in the gut. The beneficial bacteria in the gut produce a short-chain fatty acid called butyrate. Butyrate helps keep the pH in the gut lower, tightens the ileocecal valve, and provides fuel for the cells of the colon. Watch the above video for more information on how resistant starch can help improve your SIBO.

My Favorite Resistant Starch

  • Type 2 resistant starch—unripened banana flour by Wedo.
  • Type 3 resistant starch—potato flour by Bob’s Red Mill.

Instructions: If you have significant SIBO, start with just 1 tsp of resistant starch and work up to 2 tbs. If you have any significant gas or bloating after taking the resistant starch, half the dose the next day. When in doubt start slow. Gas and bloating are surefire signs that you have SIBO.

I can take 2 tbs of resistant starch two times per day without any symptoms. Some people may have to use herbal medicines to significantly knock down the SIBO before the resistant starch can be tolerated. Make sure you work with your functional-medicine practitioner to support you in the process.

On a low-carbohydrate diet, the E.rectale and the Roseburia bacteria can significantly decline. Adding in resistant starch can help prevent this decline in beneficial bacteria while maintaining a low-carbohydrate eating plan. Some people are carbohydrate sensitive and need to keep their carbohydrates down, and this provides an excellent option to get the best of both worlds.

Feel free to click here if you need help!


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.