Resistant Starch to Improve Your Gut Health

By Dr. Justin Marchegiani

What is Resistant Starch?

When we hear the word “starch,” a lot of us think of unhealthy carbohydrate-heavy foods. But not all starches are created equally. Resistant starch works differently than processed carbs like pizza and pasta–resistant starch passes through the body without spiking blood sugar without even knocking you out of ketosis!

Resistant starch isn’t completely broken down and absorbed by the body–it passes through undigested which allows you to consume resistant starch without getting thrown out of ketosis and without having blood sugar spikes that come with other starches. Research shows that resistant starch actually stabilizes blood sugar and also acts as a prebiotic to promote healthy gut bacteria.

Types of Resistant Starches

There are two main sources of resistant starches that I recommend: unripened banana flour, and cooled potato flour. 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 have an autoimmune condition, try banana flour or plantain flour first. While I personally have used both, I prefer unripened banana flour because I have an autoimmune thyroid condition. Some of my patients do better with the potato flour so you may want to experiment and see which one works best for you.

What Are the Benefits of Resistant Starch?

The goal of using resistant starch is to feed the beneficial bacteria in our small intestine. Many patients that I work with need to do a keto diet or a lower carbohydrate diet to help address and correct blood-sugar imbalances.

Typically, a lower-carbohydrate, higher-fat diet like the keto diet can be a great tool in helping to stabilize the blood sugar. Lowering carb intake also helps take stress off the adrenals/pancreas, thus stabilizing the up and down flows of blood sugar. While this diet can be very beneficial for most people, some research shows that going low-carb can reduce certain good bacteria from our gut population.

Adding resistant starches can help feed and promote the growth of beneficial bacteria in our gut by producing butyric acid—the same fat as butter, essentially. This helps to keep our small intestine more acidic and prevent SIBO (Small Intestinal Bacterial Overgrowth) from coming up from the colon into the small intestine. Butyric acid has also been shown to lower inflammation and fight off cancer cells!

Some people may get a little bit constipated due to the shifts in bacteria on a low-carbohydrate diet. This can be resolved by upping vegetables intake (nonresistant starch polysaccharides) and adding in resistant starch in the two forms mentioned above.

Resistant starch is also used for weight loss as it promotes satiety–which makes you feel fuller for longer–and can prevent cravings. Additionally, further studies have shown that resistant starch can improve insulin sensitivity in subjects with the metabolic syndrome.

Are you having symptoms of a gut problem? Click here to work with a functional medicine doctor to get to the root cause.

How to Use Resistant Starch to Improve Gut Health

Typically, I start with about one teaspoon of resistant starch 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 any issues with the resistant starch (excessive gas, bloating, belching, or flatulence), simply cut the dose in half until you find the correct dose for you.

Clinical Pearl: Resistant Starch as a Tool

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 large intestine is moving back up to the small intestine. If you take a little bit of resistant starch and have any exacerbation of symptoms, like bloating, gas, bent-over pain, or excessive flatulence–that’s a sign that you more than likely have SIBO. 

SIBO can be diagnosed with expensive lab testing, which sometimes may be needed—but I recommend trying resistant starches first to see how they work for you.

Resistant Starch May Not Fix Your Gut

The goal of resistant starch is to act like a prebiotic which feeds the beneficial bacteria in your gut while increasing butyrate. The elevated levels of butyrate also make the gut environment more inhospitable, essentially 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 more serious gut issues, you may need to do more than just use resistant starch. We would start by looking for any infections and pathogens in the gut which need to be removed first.

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.

Click here to work with a functional medicine doctor to get to the root cause of your health problems.

References:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-5491.2010.02923.x

https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/resistant-starch-as-a-prebiotic-and-synbiotic-state-of-the-art/EFE1F432B77DEE660BB609DEF449D05A

https://www.ncbi.nlm.nih.gov/pubmed/20164321

https://www.ncbi.nlm.nih.gov/pubmed/22517765

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.