The SIBO Doctor Podcast: Recent Episodes
Dr Nirala Jacobi
The SIBO Doctor podcast is presented by Dr Nirala Jacobi ND, Chief Medical Officer, SIBOTest.com
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Struggling with IBS or similar symptoms? It's not just a list of discomforts—it could be a sign of something deeper. 🤔 Dr. Allison Siebecker reminds us that chronic conditions like SIBO often have underlying causes that can go unnoticed, like endometriosis or hidden sinus infections. Before you settle for an IBS diagnosis, make sure to explore all possibilities with a comprehensive health check. Don't guess—test!
Share your journey or tag a friend who needs to see this. 🔍💪 #GutHealth #SIBO #IBSAwareness #HealthCheck
🎧 And if you're searching for insights on SIBO management, tune into the latest episode of the SIBO Doctor podcast featuring our repeat guest, Dr. Allison Siebecker. Your path to better understanding and relief starts here! 🎙️🌟
Unlock the hidden truths behind the dualistic nature of Hydrogen Sulfide as our expert guests, Dr. Nirala Jacobi and Dr. Kathleen Janel joins us in our latest episode "High Dose Sulfur for IBS". This episode is a deep dive into the dichotomy that exists within our gut, exploring how this compound can simultaneously pose as a health aid and a health threat. Come join us as we learn about its role in various illnesses like Small Intestinal Bacterial Overgrowth (SIBO), Irritable Bowel Syndrome (IBS), and Inflammatory Bowel Disease (IBD) and understand how an imbalance of this compound leads to these disorders.
We will also shed light on how sulfur, commonly seen as a villain in the narrative of gut disorders, can be used as a superhero in the treatment of these conditions. Dr. Kathleen Janel, who has been a pioneer in this revolutionizing treatment approach, will share her insights and personal success stories utilizing high doses of sulfur for more than two decades. Don't miss this intriguing transformational health journey as we challenge the conventional belief systems about sulfur and its role in gut health.
In this episode of The SIBO Doctor Podcast, Dr. Nirala Jacobi discusses:
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The Gut Microbiome's Role. The gut microbiome's influence on health and disease is significant, with modern lifestyles negatively impacting its state.
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Microbiome Diversity. A diverse microbiome, akin to a healthy ecosystem, is crucial for preventing overgrowth of harmful bacteria and maintaining overall health.
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Metabolites. Bacterial genes in the microbiome produce metabolites that can indicate health status and influence mood and energy levels.
Restore the Microbiome - New online course: Dr Jacobi's strategies to rewild the microbiome, emphasizing the importance of diversity and the production of beneficial metabolites.
Resources mentioned in this podcast:
Learn more about the new Restore Your Microbiome course on The SIBO Doctor.
Order your Microbiome Insight test from Microba.
Dr. Nirala Jacobi interviews Dr. Mark Davis about helminth therapy and fecal microbiota transplantation (FMT) in the treatment of various conditions. Helminth therapy involves using tiny worm-like organisms called helminths as medicine for humans. Dr. Davis explains that there are four helminths that have been found to be safe and beneficial for humans.
These helminths can be used to treat conditions such as multiple sclerosis, ulcerative colitis, Crohn's disease, and autism spectrum disorder. FMT, on the other hand, involves transplanting fecal microbiota from a healthy donor into the gut of a patient. FMT has been found to be effective in treating conditions such as Clostridium difficile (C. diff) colitis and hepatic encephalopathy.
Dr. Davis also discusses his new ventures in Panama, where he plans to offer helminth therapy and FMT in a hospital setting. He also mentions his work on vaginal microbiota transplantation for women's health conditions.
Dr Mark Davis, ND is a 2011 graduate of NUNM, and a fellow of the American College of Naturopathic Gastroenterology. He’s on the board of directors of the Gastroenterology Association of Naturopathic Physicians, and the editorial board of the Natural Medicine Journal. Dr. Davis teaches the naturopathic gastroenterology course at Southwest College of Naturopathic Medicine, and he has focused on patients with IBD since 2016.
Today, we'll unpack some of the mechanisms that drive chronic pain with a special focus on how dietary factors, microbiome imbalances and the nervous system play a role in the development of pain. My guest today is Ananda Mahony, a naturopath with a special interest in helping people struggling with arthritis to endometriosis, to digestive pain, or any condition where pain is a predominant feature. She has developed programs for groups and individuals to help resolve chronic pain and get back into life. Ananda has completed a master's degree in pain management.
Our conversation today deep dives into the toxic effects of glyphosate on our gut microbiome, our detoxification systems and energy production system and much more. It was prompted by my ongoing search for answers for my sulfur sensitive patients and hydrogen sulfide SIBO dysbiosis. Today I'm speaking with researcher and author Dr. Stephanie Seneff.
Dr. Seneff is a senior research scientist at MIT's Computer Science and Artificial Intelligence Laboratory in Cambridge, Massachusetts. She has a BS degree from MIT in biology and MSEE and PhD degrees from MIT in electrical engineering and computer science. Her recent interests are focused on the role of toxic chemicals and micronutrient deficiencies in health and disease with a special emphasis on the pervasive herbicide, glyphosate and the mineral sulfur. So, hang on. It's a jam-packed podcast episode which I think most practitioners will enjoy.
Our conversation today deep dives into the toxic effects of glyphosate on our gut microbiome, our detoxification systems and energy production system and much more. It was prompted by my ongoing search for answers for my sulfur sensitive patients and hydrogen sulfide SIBO dysbiosis. Today I'm speaking with researcher and author Dr. Stephanie Seneff.
Dr. Seneff is a senior research scientist at MIT's Computer Science and Artificial Intelligence Laboratory in Cambridge, Massachusetts. She has a BS degree from MIT in biology and MSEE and PhD degrees from MIT in electrical engineering and computer science. Her recent interests are focused on the role of toxic chemicals and micronutrient deficiencies in health and disease with a special emphasis on the pervasive herbicide, glyphosate and the mineral sulfur. So, hang on. It's a jam-packed podcast episode which I think most practitioners will enjoy.
Mastering SIBO and IBS with Dr Nirala Jacobi. Fully revised and streamlined, my SIBO Mastery Program will teach you not just about SIBO, but also about other causes of IBS. Today because I'm relaunching this course and I'm really excited about it. It's probably the best course I've ever created for practitioners.
To sign up go to https://www.thesibodoctor.com/sibo-mastery-program
Part 2/2
If you're struggling with chronic SIBO and you're looking for your underlying cause and just can't seem to find it because let's face it, it can be complicated, this episode might be for you. Because I am talking with Dr. Alena Guggenheim, an expert in hypermobility disorders. Hypermobility disorders such as Ehlers-Danlos syndrome can be associated with relapsing SIBO and are not uncommon in the general population.
Part 1/2
If you're struggling with chronic SIBO and you're looking for your underlying cause and just can't seem to find it because let's face it, it can be complicated, this episode might be for you. Because I am talking with Dr. Alena Guggenheim, an expert in hypermobility disorders. Hypermobility disorders such as Ehlers-Danlos syndrome can be associated with relapsing SIBO and are not uncommon in the general population.
The human intestinal circadian rhythm influences gut movement, nutrient absorption, metabolism, and cell regeneration. Abnormal sleep-wake cycles and disruption of zeitgebers aggravate the circadian rhythm and make intestinal cells more vulnerable to injury. Chronic circadian rhythm disruption is linked to gastrointestinal diseases such as IBS and colorectal cancer.
Dr. Laura M. Brown, is a registered naturopathic doctor with a functional medicine approach. She recognizes patterns, removes obstacles and stimulates the body's natural mechanisms to repair damage and rebuild health. She is owner of SOUTHEND Natural Medicine, a bestselling author of Beyond Digestion.
Do you suffer from heartburn, indigestion, or reflux?
Have you been diagnosed with GERD? In part 2 of the latest episode of the SIBO Doctor podcast, I interview renowned naturopathic physician Dr Steven Sandberg-Lewis about his latest book release "Let's Be Real About Reflux" We discuss important distinctions between - GERD (gastro-esophageal reflux disease) - NERD (non-erosive reflux disease) - LPR (Laryngo-pharyngeal reflux) Join this fascinating conversation and learn about - What causes the different types of reflux - The importance of the lower esophageal sphincter (LES) - Important nutrients to support the LES - The role of saliva in neutralizing acid reflux ...and much more.
Do you suffer from heartburn, indigestion, or reflux?
Have you been diagnosed with GERD? In part 1 of the latest episode of the SIBO Doctor podcast, I interview renowned naturopathic physician Dr Steven Sandberg-Lewis about his latest book release "Let's Be Real About Reflux" We discuss important distinctions between - GERD (gastro-esophageal reflux disease) - NERD (non-erosive reflux disease) - LPR (Laryngo-pharyngeal reflux) Join this fascinating conversation and learn about - What causes the different types of reflux - The importance of the lower esophageal sphincter (LES) - Important nutrients to support the LES - The role of saliva in neutralizing acid reflux ...and much more.
I'm really excited today to talk to Dr. Heather Finley. Dr. Finley has a doctorate in clinical nutrition from Maryland University of Integrative Health. She's a registered dietician who helps people struggling with bloating, constipation and IBS find relief from their symptoms and feel excited about food again. Heather struggled with her own digestive issues for nearly 20 years and understands firsthand the impact that nutrition, lifestyle and mindset have on digestive health.
Visit Dr Finley's website here
I've got some great news. I've talked about this or mentioned it or hinted at it for some time now, but the Bi-Phasic Diet, which is part of a SIBO protocol that's been used by tens of thousands of people and practitioners since the last six years, we've finally had a chance to update it. And I thought I'd just take a chance to talk about the new things that are on offer and what's happening with the Bi-Phasic Diet and what's new about it and what's expanded. I'll also review some of the podcasts that I've released this year and what we can look forward to for the next year.
Brad Leech is an internationally recognised Clinical Nutritionist and Ayurvedic Herbalist. After entering the integrative medicine profession in 2008, Brad has taught and developed subjects at leading academic institutions in Integrative Gastroenterology, Naturopathic Medicine, Nutritional and Dietetic Medicine and Public Health Research. As Clinical Science Lead in integrated and functional medicine at Microba, his expertise in integrative gastrointestinal healthcare enables him to translate the latest science on the gut microbiome into practical clinical application. Brad has just finished his PhD at the Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney. His research involved developing the IP Guideline, an evidence-based clinical practice guideline for the management of increased intestinal permeability. His previous research has focused on autoimmune disease management, health outcomes associated with food-based probiotics and integrative healthcare management.
Brad Leech is an internationally recognised Clinical Nutritionist and Ayurvedic Herbalist. After entering the integrative medicine profession in 2008, Brad has taught and developed subjects at leading academic institutions in Integrative Gastroenterology, Naturopathic Medicine, Nutritional and Dietetic Medicine and Public Health Research. As Clinical Science Lead in integrated and functional medicine at Microba, his expertise in integrative gastrointestinal healthcare enables him to translate the latest science on the gut microbiome into practical clinical application. Brad has just finished his PhD at the Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney. His research involved developing the IP Guideline, an evidence-based clinical practice guideline for the management of increased intestinal permeability. His previous research has focused on autoimmune disease management, health outcomes associated with food-based probiotics and integrative healthcare management.
Brad Leech is an internationally recognised Clinical Nutritionist and Ayurvedic Herbalist. After entering the integrative medicine profession in 2008, Brad has taught and developed subjects at leading academic institutions in Integrative Gastroenterology, Naturopathic Medicine, Nutritional and Dietetic Medicine and Public Health Research. As Clinical Science Lead in integrated and functional medicine at Microba, his expertise in integrative gastrointestinal healthcare enables him to translate the latest science on the gut microbiome into practical clinical application. Brad has just finished his PhD at the Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney. His research involved developing the IP Guideline, an evidence-based clinical practice guideline for the management of increased intestinal permeability. His previous research has focused on autoimmune disease management, health outcomes associated with food-based probiotics and integrative healthcare management.
Brad Leech is an internationally recognised Clinical Nutritionist and Ayurvedic Herbalist. After entering the integrative medicine profession in 2008, Brad has taught and developed subjects at leading academic institutions in Integrative Gastroenterology, Naturopathic Medicine, Nutritional and Dietetic Medicine and Public Health Research. As Clinical Science Lead in integrated and functional medicine at Microba, his expertise in integrative gastrointestinal healthcare enables him to translate the latest science on the gut microbiome into practical clinical application. Brad has just finished his PhD at the Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney. His research involved developing the IP Guideline, an evidence-based clinical practice guideline for the management of increased intestinal permeability. His previous research has focused on autoimmune disease management, health outcomes associated with food-based probiotics and integrative healthcare management.
Dr. Paul Anderson is a recognized educator and clinician in integrative and naturopathic medicine with a focus on complex infectious, chronic, and oncologic illness. In addition to three decades clinical experience, he also was head of an interventional arm of a US NIH funded human research trial using IV and integrative therapies in cancer patients. He's had numerous teaching positions in medical school and has co-authored a few books, including Outside the Box Cancer Therapies and also Cancer: The Journey from Diagnosis to Empowerment. He founded a Seattle, Washington clinic focusing on cancer and chronic diseases, and now focuses his time in collaboration with clinics and hospitals around the US and other countries.
Dr. Paul Anderson is a recognized educator and clinician in integrative and naturopathic medicine with a focus on complex infectious, chronic, and oncologic illness. In addition to three decades clinical experience, he also was head of an interventional arm of a US NIH funded human research trial using IV and integrative therapies in cancer patients. He's had numerous teaching positions in medical school and has co-authored a few books, including Outside the Box Cancer Therapies and also Cancer: The Journey from Diagnosis to Empowerment. He founded a Seattle, Washington clinic focusing on cancer and chronic diseases, and now focuses his time in collaboration with clinics and hospitals around the US and other countries.
I get a lot of requests to talk about various topics and one that keeps coming up is talking about what type of testing I do in my clinic when I see patients and what kind of testing do I recommend besides breath testing for SIBO. And I thought it might be useful to discuss the top three tests that I recommend very frequently as a digestive specialist in my clinic.
How bodily structure can influence how people experience symptoms. Dr Maree Chilton is an Australian chiropractor with over 30 years experience with different approaches to diagnosing chronic illness.
Dr Jill Crista is a naturopathic doctor and bestselling author of the book, Break The Mold. She's a mold expert and health educator on neuroinflammatory conditions such as mold and mycotoxins. Link mentioned in this episode - The ERMI Code
https://yesweinspect.com/ermi-interpretation/
Dr Jill Crista is a naturopathic doctor and bestselling author of the book, Break The Mold. She's a mold expert and health educator on neuroinflammatory conditions such as mold and mycotoxins. Link mentioned in this episode - The ERMI Code https://yesweinspect.com/ermi-interpretation/
Today's topic has been requested numerous times from our listeners, life after SIBO. And many of you have asked, "I've been treated for SIBO, now what do I do? How do I prevent it from coming back?" And it's a really worthy topic to unpack.
Dr Ami Kapadia has practiced as a family medicine and integrative medicine physician since 2005, and has pursued training with the Institute for Functional Medicine and the American Academy of Environmental Medicine, and is certified by the American Board of Integrative and Holistic Medicine. She has been practicing integrative and functional medicine at Kwan-Yin Healing Arts Center in Portland since 2015, where she focuses on digestive health and autoimmune disease and with a special focus on chronic infections, allergic disease and environmental exposure in illness.
Dr Ami Kapadia has practiced as a family medicine and integrative medicine physician since 2005, and has pursued training with the Institute for Functional Medicine and the American Academy of Environmental Medicine, and is certified by the American Board of Integrative and Holistic Medicine. She has been practicing integrative and functional medicine at Kwan-Yin Healing Arts Center in Portland since 2015, where she focuses on digestive health and autoimmune disease and with a special focus on chronic infections, allergic disease and environmental exposure in illness.
Five years ago we launched our very first episode of The SIBO Doctor Podcast! Today we revisit the testing considerations in SIBO to see if anything has developed over the last five years.
Show notes
When to Test for IBS
With me today is Dr. Victoria Sampson, a very accomplished dentist who has been on the forefront of change in dentistry, publishing several studies about the oral microbiome and the relationship between the mouth and the body.
We all know about the gut microbiome, the skin, but the oral microbiome is a very special one, because it's constantly under attack, it's one of the microbiomes that is exposed all the time. Every time we breathe, we drink, we eat, we smoke, anything, the microbiome is under attack. And what also is quite interesting is that the oral microbiome is one of the only ones where it's gotten on shedding surfaces. So, our teeth. And unlike anything else in our body, our teeth do not shed. And so, that means that whilst other my microbiomes or other areas, skin, or et cetera, can shed, and the bacteria can kind of change by itself with non-shedding surfaces like the teeth, there is no way of actually changing the microbiome. And if you have poor bacteria on your teeth and you're not going in and getting them cleaned regularly, it can have some really drastic effects on the rest of your body. The oral microbiome itself is the second most diverse microbiome, just following the gut. So, it's got around 700 different species of bacteria and they amount to about two billion bacteria in the mouth at all times.
My guest is Dr. Joshua Goldenberg, who is a researcher, teacher, naturopathic doctor, and founder of the Dr. Journal Club, LLC. He's an active researcher with numerous prestigious publications, and his research focuses on SIBO, irritable bowel syndrome, evidence-informed practice, and research methodology. He is a research investigator at the Helfgott Research Institute and Visiting Research Scholar at the University of Technology Sydney. He lectures widely and currently teaches post-graduate students at Helfgott in advanced evidence synthesis methods.
Today I will be talking to you about common SIBO treatment mistakes that I encounter in my practice.
After dealing with her own health issues, Shivan made it her mission to demystify her condition and to share that information with others who were struggling. Her special skill is finding and connecting with the leading expert doctors and connecting those experts with the people who need their help. And she has just published her book, Healing SIBO.
Today, I'm speaking with Dr. Diane Mueller, a naturopathic physician who graduated in 2011. She is a survivor of IBS, Lyme Disease, and mold illness. Dr. Mueller is passionate about bringing research, understanding, and compassion to those with these diseases. She has co-authored an upcoming book, which is to be released in May 2021, called Use Your Mind to Heal Your Mold and Lyme.
With me today is Ashok Gupta, the Founder of the Gupta Program, which I'd heard about from colleagues at SIBO conferences and from my patients through the years and how effective it is in overcoming chronic illness through the use of neuroplasticity or brain retraining.
The Gupta Program
Free Membership Access for Practitioners
Part two of our discussion with Dr. Steven Sandberg-Lewis. The author of Functional Gastroenterology shares his incredible wealth of knowledge on all things H. pylori - it's got a long history. Where we are now, what's happening with diagnosis and treatment, and some really good insights for practitioners as to what's the current status of H. pylori.
Dr. Steven Sandberg-Lewis, the author of Functional Gastroenterology shares his incredible wealth of knowledge on all things H. pylori - it's got a long history. Where we are now, what's happening with diagnosis and treatment, and some really good insights for practitioners as to what's the current status of H. pylori.
In this episode, I talk with Dr. Lenny Weinstock about Mast Cell Activation Syndrome, or MCAS. Dr. Weinstock is a gastroenterologist and researcher known in the SIBO community for his expertise in SIBO and associated conditions such as rosacea and restless leg syndrome. Links mentioned in this podcast: MCAS: A primer for Gastroenterologists
Link: https://www.researchgate.net/publication/340872730_Mast_Cell_Activation_Syndrome_A_Primer_for_the_Gastroenterologist
With me today is Dr. Mark Pimentel who really needs no introduction to the SIBO community. He's the executive director of the MAST program or Medically Associated Science and Technology. He's professor of medicine at Geffen School of Medicine at Cedar-Sinai Medical Center in L.A. A few of Dr. Pimentel's most significant accomplishments include the discovery of rifaximin as a treatment for IBS. He also developed the first blood test for IBS based on IBS being derived from acute gastroenteritis; the antibody testing. He described the association between IBS and bacterial overgrowth, which forms the basis of microbiome therapies in this condition, as well as uncovering that methanogens are causing constipations in humans.
Dr. Allison Siebecker has been educating us for about a decade now about all things SIBO, and has now put together a new sort of SIBO summit. We also start off this podcast episode with just some of the big SIBO research and treatement updates in 2020.
Click here to join Next Steps for Treating Tough SIBO - Masterclass Summit + Research Updates
For almost 40 years, Dr. Sally LaMont has been a licensed naturopathic doctor and acupuncturist, as well as an educator and a cook, and she sees patients at her Marin Natural Medicine Clinic in Larkspur, California. She focuses on healthy aging, digestive issues, metabolic and hormonal imbalances, pre-diabetes, and dementia. She's created drsallyskitchen.com for her patients and the public to share strategies and recipes to beat chronic disease using food as medicine.
Dr LaMont's website and course
Resources for Trauma Healing continues with part two.
Rupda is a certified Holistic Counsellor with S.I.A.F. and a certified Somatic Experiencing Practitioner from Peter Levine’s SE® Institute of Trauma Healing. She is an NLP Practitioner, studying under John Grinder; has Non Violent Communication Training; and studied Hypnosis Mastery with Stephan Gilligan; Life Mastery with Tony Robbins. Rupda has also studied the Enneagram & Essence work.
Since 1983, Rupda produced a broad range of events and gatherings worldwide. She has lived in Europe, India, USA and Australia and is also the founder of Divine Meetings and she has been with Path of Love since 2000. Her passion is in inspiring people to reconnect with themselves and reclaim their joy in life.
Rupda is a certified Holistic Counsellor with S.I.A.F. and a certified Somatic Experiencing Practitioner from Peter Levine’s SE Institute of Trauma Healing. She is an NLP Practitioner, studying under John Grinder; has Non Violent Communication Training; and studied Hypnosis Mastery with Stephan Gilligan; Life Mastery with Tony Robbins. Rupda has also studied the Enneagram & Essence work.
Since 1983, Rupda produced a broad range of events and gatherings worldwide. She has lived in Europe, India, USA and Australia and is also the founder of Divine Meetings and she has been with Path of Love since 2000. Her passion is in inspiring people to reconnect with themselves and reclaim their joy in life.
Dr. Will Bulsiewicz is a New York Times bestselling author of the book Fiber Fueled. He's also an award winning gastroenterologist, gut health expert, and the author of more than 20 articles in top American gastroenterology journals.
Dr. Will Bulsiewicz is a New York Times bestselling author of the book Fiber Fueled. He's also an award winning gastroenterologist, gut health expert, and the author of more than 20 articles in top American gastroenterology journals.
With me today is a returning guest, it's Dr. Farshid Sam Rahbar, who is a holistic and integrative gastroenterologist and the medical director at the LA Integrative Gastroenterology. In 2013, he delved into the relationship between tick-borne Lyme disease, with a special interest in gastrointestinal manifestations. Since this time he has witnessed clinical patterns involving the role of infections, acute and chronic, in causing ongoing GI related conditions and symptoms. Dr. Rahbar's special interest areas also includes dysbiosis, SIBO and leaky gut.
Download Dr Rahbar's SIBOCon 2019 Presentation
Download SIBO Pattern Recognition Presentation
With me today is a returning guest, it's Dr. Farshid Sam Rahbar, who is a holistic and integrative gastroenterologist and the medical director at the LA Integrative Gastroenterology. In 2013, he delved into the relationship between tick-borne Lyme disease, with a special interest in gastrointestinal manifestations. Since this time he has witnessed clinical patterns involving the role of infections, acute and chronic, in causing ongoing GI related conditions and symptoms. Dr. Rahbar's special interest areas also includes dysbiosis, SIBO and leaky gut.
Download Dr Rahbar's SIBOCon 2019 Presentation
Download SIBO Pattern Recognition Presentation
Dr. Steven Sandberg-Lewis is professor at National University of Natural Medicine focusing on gastroenterology. Within gastroenterology, he has a special interest and expertise in inflammatory bowel disease, IBS, and SIBO. He's the author of the medical text book, Functional Gastroenterology: Assessing and Addressing the Cause of Functional Digestive Disorders. He has recently opened Hive Mind Medicine, a clinic focused on digestive and mental health in Portland, Oregon.
Dr. Hawrelak is a researcher, educator, naturopath, and nutritionist with over two decades of clinical experience. He practices at Gould’s Natural Medicine, an over 130 years old natural medicine apothecary and clinic in Hobart, Tasmania. Today's topic is so fascinating to many of our practitioners that are in the field of gastroenterology because we are talking about gut parasites, and Dr Hawrelak just recently released a course about blastocystis and Dientamoeba fragilis.
Dr. Hawrelak is a researcher, educator, naturopath, and nutritionist with over two decades of clinical experience. He practices at Gould’s Natural Medicine, an over 130 years old natural medicine apothecary and clinic in Hobart, Tasmania. Today's topic is so fascinating to many of our practitioners that are in the field of gastroenterology because we are talking about gut parasites, and Dr Hawrelak just recently released a course about blastocystis and Dientamoeba fragilis.
Lara Briden is a naturopathic doctor and the period revolutionary—leading the change to better periods. Informed by a strong science background and more than twenty years with patients. Lara is a passionate communicator about women’s health and alternatives to hormonal birth control. Her book Period Repair Manual is a manifesto of natural treatment for better hormones and better periods and provides practical solutions using nutrition, supplements, and natural hormones. Now in its second edition, the book has been an underground sensation and has worked to quietly change the lives of tens of thousands of women.
Nickel Paper link: https://www.ncbi.nlm.nih.gov/pubmed/32012984
Lara Briden is a naturopathic doctor and the period revolutionary—leading the change to better periods. Informed by a strong science background and more than twenty years with patients, Lara is a passionate communicator about women’s health and alternatives to hormonal birth control. Her book Period Repair Manual is a manifesto of natural treatment for better hormones and better periods and provides practical solutions using nutrition, supplements, and natural hormones. Now in its second edition, the book has been an underground sensation and has worked to quietly change the lives of tens of thousands of women.
The Nickel Paper mentioned in this show may be accessed here: https://www.ncbi.nlm.nih.gov/pubmed/32012984
Andrea McBeth is a Naturopathic Doctor with a passion for shifting perspectives toward microbiome-centered health. Her scientific background includes a degree in biochemistry from the University of San Diego and research pursuits in various areas of molecular and cellular biology. After years in cancer research she was called to the path of naturopathic medicine. She graduated from The National University of Natural Medicine in 2017. As a licensed N.D. in Oregon and Washington, she focuses her clinical care on functional gastrointestinal and autoimmune issues. In conjunction with her functional medicine practice, she founded and runs a stool bank that provides Fecal Microbiota Transplant for the treatment of resistant Clostridium difficile infection.
Are You Missing Mold Illness In Your Patients?
Today I have Dr. Jill Crista with me who is a naturopathic doctor and bestselling author of the book, Break The Mold and a new practitioner training course [ visit course page ]. She's a mold expert and nationally recognized health educator on neuro inflammatory conditions such as mold and mycotoxins. Her passion is improving health through education and bridging gaps between medical research and clinical practice. She writes books and offers online courses, and we'll be talking about that today because I stumbled across Dr. Crista on Instagram. Yeah, I saw these little videos that kept popping up of her giving mold advice of how to reduce mold exposure.
Dr Crista's Mold Training Course For Medical Practitioners
Are You Missing Mold Illness In Your Patients?
Today I have Dr. Jill Crista with me who is a naturopathic doctor and bestselling author of the book, Break The Mold and a new practitioner training course [ visit course page ]. She's a mold expert and nationally recognized health educator on neuro inflammatory conditions such as mold and mycotoxins. Her passion is improving health through education and bridging gaps between medical research and clinical practice. She writes books and offers online courses, and we'll be talking about that today because I stumbled across Dr. Crista on Instagram. Yeah, I saw these little videos that kept popping up of her giving mold advice of how to reduce mold exposure.
Dr Crista's Mold Training Course For Medical Practitioners
Dr Nirala Jacobi wraps up the year with this informative recap of 2019 in the world of SIBO, as well as a segment on the underlying causes of SIBO.
Free download - What Caused My SIBO [Free Download]
Today I'm speaking with Dr. Mark Pimentel and of course, he's no stranger to anyone in the SIBO community. He's been really instrumental in many IBS and SIBO studies and a lot of research that's been happening over the last few years. I learned about Dr. Pimentel through his book, The New IBS Solution, about 10 years ago. He is the executive director of the Medically Associated Science and Technology program at Cedars-Sinai. He's a professor of medicine at Geffen School of Medicine and associate professor of Cedars-Sinai Medical Center in Los Angeles. He's very active in research and has served as a principal investigator or co-investigator for numerous clinical studies. And of course we know him as the developer or discoverer of the anti-vinculin and anti-CdtB antibodies that predict whether or not you have SIBO or autoimmune IBS. He also discovered the use of Lovastatin for methanogens.
Today I'm speaking with Dr. Mark Pimentel and of course, he's no stranger to anyone in the SIBO community. He's been really instrumental in many IBS and SIBO studies and a lot of research that's been happening over the last few years. I learned about Dr. Pimentel through his book, The New IBS Solution, about 10 years ago. He is the executive director of the Medically Associated Science and Technology program at Cedars-Sinai. He's a professor of medicine at Geffen School of Medicine and associate professor of Cedars-Sinai Medical Center in Los Angeles. He's very active in research and has served as a principal investigator or co-investigator for numerous clinical studies. And of course we know him as the developer or discoverer of the anti-vinculin and anti-CdtB antibodies that predict whether or not you have SIBO or autoimmune IBS. He also discovered the use of Lovastatin for methanogens.
Dr Johan Van Den Bogaerde completed his undergraduate training in South Africa, with postgraduate training in the United Kingdom at Cambridge, St. Mark’s and Hammersmith Hospitals.
Dr Van Den Bogaerde is particularly interested in the microbiome, and has recently completed a trial looking at fecal transplantation in patients with ulcerative colitis, which had encouraging results. Dr Van Den Bogaerde believes Gastroenterology is an exciting and important field, and has very broad interests including the study of the microbiome, esophageal pathology, motility disturbances, inflammatory bowel disease and functional bowel disease.
He has been performing general, interventional and hepatobiliary procedures at Sunshine Coast University Private Hospital for the past four years.
He is also very interested in new techniques, particularly interventional endoscopic techniques, and works closely with a strong team of surgical colleagues at Sunshine Coast University Private Hospital including Physicians, Renal Physicians and Cardiologists.
Topics discussed include:
- Fecal Microbiota Transplant (FMT)
- Inflammatory and functional bowel disease - ulcerative colitis
- The microbiome
- Motility disorders
- Esophageal disorders
Dr Johan Van Den Bogaerde completed his undergraduate training in South Africa, with postgraduate training in the United Kingdom at Cambridge, St. Mark’s and Hammersmith Hospitals.
Dr Van Den Bogaerde is particularly interested in the microbiome, and has recently completed a trial looking at fecal transplantation in patients with ulcerative colitis, which had encouraging results. Dr Van Den Bogaerde believes Gastroenterology is an exciting and important field, and has very broad interests including the study of the microbiome, esophageal pathology, motility disturbances, inflammatory bowel disease and functional bowel disease.
He has been performing general, interventional and hepatobiliary procedures at Sunshine Coast University Private Hospital for the past four years.
He is also very interested in new techniques, particularly interventional endoscopic techniques, and works closely with a strong team of surgical colleagues at Sunshine Coast University Private Hospital including Physicians, Renal Physicians and Cardiologists.
Topics discussed include:
- Fecal Microbiota Transplant (FMT)
- Inflammatory and functional bowel disease - ulcerative colitis
- The microbiome
- Motility disorders
- Esophageal disorders
Join me today on my back porch with my very good friend and colleague Sarita Ford, who works as a hypnotherapist and holistic counselor here at the Biome Clinic in Byron Bay. Today's topic is rest and digest, and follows on from podcast episodes 46 and 47 where we discussed the role of the nervous system and gut disorders.
Nicola Dehlinger, ND, graduated from SCNM in 2004. Dr Nicola sees clients from around the world in her naturopathic medical practice, Pura Vida Natural Healthcare, in Durango, CO. She is an expert in the treatment of anxiety, depression, and insomnia. She is able to minimize supplements and medications as her patients become empowered to heal themselves. In addition to seeing clients, Dr Nicola leads group and private retreats. She also teaches a variety of online and in-person classes. In her free time, you can find Dr Nicola in the mountains or the kitchen, enjoying time with her husband, son, and their dogs. Website: www.puravidahealthcare.com
Nicola Dehlinger, ND, graduated from SCNM in 2004. Dr Nicola sees clients from around the world in her naturopathic medical practice, Pura Vida Natural Healthcare, in Durango, CO. She is an expert in the treatment of anxiety, depression, and insomnia. She is able to minimize supplements and medications as her patients become empowered to heal themselves. In addition to seeing clients, Dr Nicola leads group and private retreats. She also teaches a variety of online and in-person classes. In her free time, you can find Dr Nicola in the mountains or the kitchen, enjoying time with her husband, son, and their dogs. Website: www.puravidahealthcare.com
Impaired motility is a major underlying cause of SIBO. Two thirds of SIBO cases relapse. In today's two-part episode, we discuss how Prokinetics have emerged to become a critical tool to lengthen the remission period.
ABOUT DR ALLISON SIEBECKER
Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic and has specialized in the treatment of SIBO since 2010.
Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, Board of Advisor for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums, teaches continuing education classes for physicians, and is the author of the free educational website siboinfo.com.
In 2005, 2013 and 2015 she received the Best in Naturopathy award from the Townsend Letter, for her articles: “Traditional Bone Broth in Modern Health and Disease”, “Small Intestine Bacterial Overgrowth: Often Overlooked Cause of IBS” and “SIBO: Dysbiosis Has A New Name”. Dr. Siebecker is currently writing a book synthesizing the SIBO data into one source.
Impaired motility is a major underlying cause of SIBO. Two thirds of SIBO cases relapse. In today's two-part episode, we discuss how Prokinetics have emerged to become a critical tool to lengthen the remission period.
ABOUT DR ALLISON SIEBECKER
Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic and has specialized in the treatment of SIBO since 2010.
Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, Board of Advisor for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums, teaches continuing education classes for physicians, and is the author of the free educational website siboinfo.com.
In 2005, 2013 and 2015 she received the Best in Naturopathy award from the Townsend Letter, for her articles: “Traditional Bone Broth in Modern Health and Disease”, “Small Intestine Bacterial Overgrowth: Often Overlooked Cause of IBS” and “SIBO: Dysbiosis Has A New Name”. Dr. Siebecker is currently writing a book synthesizing the SIBO data into one source.
Today I'm delighted to have Anne Criner with me, who is my colleague here at the Biome Clinic. She's a naturopath and nutritionist and my co author for my vegetarian SIBO Bi-Phasic diet and that's the topic of this episode - How to treat SIBO in vegans and vegetarians. This is been a really exciting release for us in terms of the SIBO biphasic diet that's vegetarian and vegan. We dissect it a little bit today as to what we have accomplished, who we target and how to really implement it in the practitioners flow of treatment.
Download the Vegetarian SIBO Bi-Phasic diet on https://www.thesibodoctor.com/vegetarian-sibo-bi-phasic-diet-2019/
Today we are speaking with Julianne Grant. She's an experienced Melbourne-based naturopathic practitioner who has a very special interest in the management of chronic disease, including autoimmune conditions, inflammatory conditions, chronic infections, and immune dysregulation. She's also been a researcher, technical writer, presenter, and educator for one of the herbal companies here in Australia called OptimalRx. She's been in practice and has been in this industry for almost two decades.
I'm really happy to be talking to her today about immune modulation and herbs. She gave a really good presentation at the NHAA conference just a month ago or so about how herbs can affect the immune response. I thought I'd take the opportunity, and talk with her today about all the wonderful things that herbs can do for the immune system.
Today we are speaking with Julianne Grant. She's an experienced Melbourne-based naturopathic practitioner who has a very special interest in the management of chronic disease, including autoimmune conditions, inflammatory conditions, chronic infections, and immune dysregulation. She's also been a researcher, technical writer, presenter, and educator for one of the herbal companies here in Australia called OptimalRx. She's been in practice and has been in this industry for almost two decades.
I'm really happy to be talking to her today about immune modulation and herbs. She gave a really good presentation at the NHAA conference just a month ago or so about how herbs can affect the immune response. I thought I'd take the opportunity, and talk with her today about all the wonderful things that herbs can do for the immune system.
In today’s podcast Dr Nirala Jacobi is in conversation with digestive expert Dr Lisa Shaver, all about celiac disease, non-celiac gluten sensitivity, and SIBO.
Dr. Lisa Shaver is a ND, LAc with a passionate interest in digestive disorders (celiac disease/non-celiac gluten sensitivity, GERD, SIBO, IBS). Other expertise areas include hormonal imbalances, autoimmune conditions and neurotransmitter balancing.
Dr. Shaver has lectured at the following: AANP, Integrative SIBO Conferences, SIBO Symposiums, GastroANP/NUNM Gastroenterology Conferences, AZNMA Gastroenterology Conference, Institute of Women’s Health, Food As Medicine, amid other speaking engagements.
She is past president and past board member of the Gastroenterology Association of Naturopathic Physicians. She is the Gluten Intolerance Group of Portland branch manager since 2008.
In today’s podcast Dr Nirala Jacobi is in conversation with digestive expert Dr Lisa Shaver, all about celiac disease, non-celiac gluten sensitivity, and SIBO.
Dr. Lisa Shaver is a ND, LAc with a passionate interest in digestive disorders (celiac disease/non-celiac gluten sensitivity, GERD, SIBO, IBS). Other expertise areas include hormonal imbalances, autoimmune conditions and neurotransmitter balancing. Dr. Shaver has lectured at the following: AANP, Integrative SIBO Conferences, SIBO Symposiums, GastroANP/NUNM Gastroenterology Conferences, AZNMA Gastroenterology Conference, Institute of Women’s Health, Food As Medicine, amid other speaking engagements. She is past president and past board member of the Gastroenterology Association of Naturopathic Physicians. She is the Gluten Intolerance Group of Portland branch manager since 2008.
In today’s podcast, part 2 of Dr Nirala Jacobi in conversation with mold specialist, Dr Sandeep Gupta, all about mold toxicity and SIBO.
Dr Gupta is a specialist general practitioner who is a member of the RACGP special interests group in integrative medicine. He graduated from medical school at the University of Queensland in 1999. Since then Dr Gupta served in a range of public and private hospitals in the South-East Queensland region, serving as cardiology, medical and anesthetic registrar. He also has approximately five years of experience in working in Intensive Care, particularly in the area of post-cardiac surgery care.
Dr Gupta then went on to invest many years training in integrative medicine, and was awarded a Fellowship of the Australasian College of Nutritional and Environmental Medicine (ACNEM) in 2008 and a Fellowship of the Royal Australian College of General Practitioners (RACGP) in 2010. He also has a physician training certification with Dr Ritchie Shoemaker in chronic inflammatory illness and a Masters of Nutrition with Dr Gabriel Cousens in diabetes and living food nutrition. Other major influences include William Wolcott CN, Robert Marshall PhD, and Dietrich Klinghardt MD PhD.
He established the Lotus Institute of Holistic Health in 2017 to provide training in integrative medicine for those who seek it. He has also had an advocacy role in integrative medicine with a prior position on the ACNEM board, and a current position on the Australian Integrative Medicine Association (AIMA) advocacy committee, and is a founding board member for the Australian Chronic Infectious & Inflammatory Disease Society (ACIIDS) and the International Society of Environmentally Acquired Illness (ISEAI).
Dr Gupta strives to walk his talk in his own life, keeps up to date with current developments in the field, and genuinely aims to approach clients with respect, service, and empathy. He believes listening and validation of an individual journey are some of the most powerful gifts the practitioner can give anyone.
In today’s podcast, part 2 of Dr Nirala Jacobi in conversation with mold specialist, Dr Sandeep Gupta, all about mold toxicity and SIBO.
Dr Gupta is a specialist general practitioner who is a member of the RACGP special interests group in integrative medicine. He graduated from medical school at the University of Queensland in 1999. Since then Dr Gupta served in a range of public and private hospitals in the South-East Queensland region, serving as cardiology, medical and anesthetic registrar. He also has approximately five years of experience in working in Intensive Care, particularly in the area of post-cardiac surgery care.
Dr Gupta then went on to invest many years training in integrative medicine, and was awarded a Fellowship of the Australasian College of Nutritional and Environmental Medicine (ACNEM) in 2008 and a Fellowship of the Royal Australian College of General Practitioners (RACGP) in 2010. He also has a physician training certification with Dr Ritchie Shoemaker in chronic inflammatory illness and a Masters of Nutrition with Dr Gabriel Cousens in diabetes and living food nutrition. Other major influences include William Wolcott CN, Robert Marshall PhD, and Dietrich Klinghardt MD PhD.
He established the Lotus Institute of Holistic Health in 2017 to provide training in integrative medicine for those who seek it. He has also had an advocacy role in integrative medicine with a prior position on the ACNEM board, and a current position on the Australian Integrative Medicine Association (AIMA) advocacy committee, and is a founding board member for the Australian Chronic Infectious & Inflammatory Disease Society (ACIIDS) and the International Society of Environmentally Acquired Illness (ISEAI).
Dr Gupta strives to walk his talk in his own life, keeps up to date with current developments in the field, and genuinely aims to approach clients with respect, service, and empathy. He believes listening and validation of an individual journey are some of the most powerful gifts the practitioner can give anyone.
Dr Kate Broderick is a naturopath, five-element acupuncturist, educator and writer. Her naturopathic practice in the Adelaide Hills, Anam Chara Natural Health, gravitates strongly to the traditions of individualised diet/self-care, herbal medicine, mind/body therapies, and naturopathic hydrotherapy. She received her Bachelor of Science from Texas A&M University, Doctorate of Naturopathic Medicine from Bastyr University, and Diploma of Acupuncture from the Wu Hsing Tao School.
Part 2 of 2
Dr Kate Broderick is a naturopath, five-element acupuncturist, educator and writer. Her naturopathic practice in the Adelaide Hills, Anam Chara Natural Health, gravitates strongly to the traditions of individualised diet/self-care, herbal medicine, mind/body therapies and naturopathic hydrotherapy. She received her Bachelor of Science from Texas A&M University, Doctorate of Naturopathic Medicine from Bastyr University, and Diploma of Acupuncture from the Wu Hsing Tao School. Kate has worked in various roles in naturopathic academia since 2009, including serving as the Director of Education at Endeavour College of Natural Health from 2014-2016, and is currently a sessional lecturer in Naturopathy at Endeavour. She is a member of the Naturopaths and Herbalists Association of Australia and is registered as an acupuncturist (currently non-practicing) by the Australian Health Practitioner Regulation Agency (AHPRA). She is a co-author of the chapter on Naturopathic Hydrotherapy in the latest edition of the Textbook of Natural Medicine and author of the chapter on Naturopathic Philosophy in the recently released 2nd edition of Clinical Naturopathic Medicine.
Topics discussed in this episode include:
- Dr Broderick’s beginnings with hydrotherapy.
- How hydrotherapy relates to digestive health.
- How and why hydrotherapy works.
- How hydrotherapy affects general and specific areas of the body.
-
3 specific treatment protocols for enhancing digestive capacity, vitality, reducing anxiety, assisting sleep, stimulating immunity, and increasing blood flow.
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- The Alternating Foot Bath
- The Arm Rinse / Arm Bath
- The Short Wrap
- Cautions and contraindications of hydrotherapy.
- Tips for hydrotherapy in daily life.
- The hydrotherapeutic healing crisis - what to expect and who is likely to experience it.
Elder naturopaths mentioned
- Dr Nancy Welliver
- Dr Cathy Rogers
Resources
- Father Sebastian Kneipp
-
- Father of hydrotherapy in Germany
- The Short Wrap
-
- See SIBODoctor.com to download Dr Broderick’s treatment handout.
- Dr Kate Broderick
-
- Anam Chara Natural Health
-
- 797 Onkaparinga Valley Road
- Oakbank, SA, Australia 5243
- Anam Chara Natural Health on Facebook
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https://thesibodoctor.com/sibo-doctor-podcasts
Part 2 - Dr Nirala Jacobi is in conversation with Dr Ginger Nash about the importance of lymphatics.
In today’s episode, Dr Nirala Jacobi is in conversation with Dr Ginger Nash about the importance of lymphatics.
Dr Nash graduated from the National College of Naturopathic Medicine in 1998 and has been 20 years in clinical practice doing excellent work in women’s health. She uses natural hormone balancing techniques without the use of hormone replacement. Dr Nash also uses complex homoeopathy, herbal medicine and nutrigenomics. Dr Nash has been a professor at the University of Bridgeport College of Naturopathic Medicine Clinic for six years and has taught seminars for other health care professionals throughout the US and Canada. Dr Nash is a sought-after speaker and has recently launched an online health program for women called Feminology.
Topics discussed include
- The importance of the lymphatic system
- Lymphatic system serves as the entry point for all the dietary lipids, which are taken up by the enterocytes (epithelial cells of the intestines) and the whole mesentery - the lymphatic support system that surrounds the small intestines.
- There is an intricate relationship between the lymphatic system and the gut.
- What is Dr Nash always considering when she starts treatment with a new patient and for continued patient care?
- If our lymphatic system stopped flowing we would die within a few hours.
- Lymphatic testing as part of initial workup.
- Key lymphatic tissue areas to inspect.
- The connections between lymphatic health and hormones.
- Miasmatic approach - what is it?
- Medicines and considerations to work on drainage, normalising, and detoxifying the emunctories.
- Reckeweg medicines
- Organ system approach
- Terrain approach
- Considering miasmatic influences
- What medicines are suggested to start with for sensitive patients?
- What identifying symptoms or factors would alert the practitioner to look to the support the lymphatics in particular?
- Essential roles of the lymphatic system
- Immune system
- Moving immunoglobulins and white blood cells around the body
- Detoxification
- Eliminating toxins from the body
- Help the body to eliminate FIRST before doing more pointed detoxification protocols and medicines.
- People with massive reactions to detoxification and the link to an overloaded lymphatic system.
- Chronic digestive disorders
- How is the enteric nervous system connected with both the lymphatic system and immune system, and how do infections impact them all?
- Scars or taught sections of the body and how this impacts on lymphatic flow.
- The link between constipation, SIBO, the lymphatics, and reactivity.
- Home treatments to help move the lymph.
- How to consider the lymph before doing large detox treatments.
- Far infrared sauna and Swedish sauna protocols.
- The 4 Miasms explained.
- The importance of the fascia in controlling the whole body.
- Lymphatics and brain health.
- Insights into homoeopathy.
- Herbal remedies to stimulate and cleanse the lymphatics.
- Extracellular matrix
- Fluid outside of the cell - how to think of it in relation to the lymphatics and nutrient uptake into cells.
- Ginger Nash’s clinical pearls.
- Immune system
Resources
- Dr Ginger Nash
- Dr Nash's website - .com
- Feminology Facebook Group - co-founded with Dr Tara Naik
- org launching soon
- Practitioner training coming soon
- Email drgingernash@gmail.com to join the practitioner email list.
- Dr Ginger Nash’s article on NDNR
- The Lymphatic System - A Critical Factor in Female Hormone System Balance
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In today’s episode, Dr Jacobi is in conversation with Dr Megan Taylor about Digestive Disorders in Children.
Dr Taylor practices primary care in naturopathic gastroenterology for adults and children with digestive complaints, allergies, and autoimmune disease. She earned her Doctorate in Naturopathic Medicine from the National University of Natural Medicine in Portland, Oregon, graduating with honours. Dr Taylor completed two years of postgraduate residency training in primary care and naturopathic gastroenterology under the mentorship of Dr Steven Sandberg-Lewis and Dr Allison Siebecker. She is also the Vice President of the GastroANP.
Part 2 of the conversation with Dr Paul Anderson all about biofilm and SIBO.
Dr Anderson is a Naturopathic Doctor and medical director of the Advanced Medical Therapies Clinic focusing on the care of patients with cancer and chronic disease. Former positions include Professor of Pharmacology and Clinical Medicine at Bastyr University and Chief of IV Services for Bastyr Oncology Research Centre. Dr Anderson is a graduate of NCNM and began instructing classes at naturopathic medical schools in the early 1990s. He continues to hold board review classes and CME courses for most of the Canadian and US ND programs and continues his educational outreach through www.consultdranderson.com.
Apple Users
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- Open Apple's Podcast app.
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- Tap the Reviews tab.
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Part 1 of the conversation with Dr Paul Anderson all about biofilm and SIBO.
Dr Anderson is a Naturopathic Doctor and medical director of the Advanced Medical Therapies Clinic focusing on the care of patients with cancer and chronic disease. Former positions include Professor of Pharmacology and Clinical Medicine at Bastyr University and Chief of IV Services for Bastyr Oncology Research Centre. Dr Anderson is a graduate of NCNM and began instructing classes at naturopathic medical schools in the early 1990s. He continues to hold board review classes and CME courses for most of the Canadian and US ND programs and continues his educational outreach through www.consultdranderson.com.
Apple Users
How to leave us a review on your iPhone or Ipad
- Open Apple's Podcast app.
- Go to the Search tab.
- Enter ‘The SIBO Doctor Podcast’.
- Tap ‘Search’ on your keypad.
- Tap the SIBO Doctor icon when it comes up.
- Tap the Reviews tab.
- Scroll down to ‘Ratings & Reviews’
- Tap the stars to leave a rating
- Tap ‘Write a Review’ to leave a review’
- Hit send
Android Users
How to leave us a review on your device
- Open stitcher
- Go to the Search tab.
- Enter ‘The SIBO Doctor Podcast’.
- Hit search
- Tap the SIBO Doctor icon when it comes up.
- Scroll down to ‘Be the first to review this show’.
- Tap the stars to leave a rating
- Enter your review
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In today’s episode, Dr Nirala Jacobi is in conversation with renowned SIBO specialist, Naturopathic Gastroenterologist and Professor, Dr Steven Sandberg-Lewis.
Dr Sandberg-Lewis is a highly regarded and well known naturopathic physician. He has been a professor at the National University of Naturopathic Medicine (NUNM) since 1985, in Portland, Oregon. Dr Sandberg-Lewis has a part-time clinical practice and is the author of several Townsend Letter award-winning articles, and of the medical textbook ‘Functional Gastroenterology: Assessing and Addressing the Causes of Functional Gastrointestinal Disorders’. He has also been named one of the Top Docs in Portland Oregon in 2014.
Topics discussed include:
- How are proton pump inhibitors (PPI) related to SIBO?
- How the 3 main secretions at the upper gate of the small intestine are bacteriostatic, and how hypochlorhydria and PPI use can support SIBO development.
- Heidelberg testing and Weakly Acid Reflux.
- How alkaline reflux can trigger the same symptoms as acid reflux.
- Loss of stomach mucosa in the absence of the acidic trigger.
- Atrophic gastritis - what is it and how common is it?
- Is reflux after meals normal?
- Esophagitis - what causes it and what is it?
- The role of alkaline saliva in bathing the esophagus to help neutralise acid that may come up.
- Leaky mucosa in the stomach, the connection to PPIs, and the link to food intolerances and allergies.
- Dilated intercellular spaces (DIS) in the oesophagus and superficial nerve irritation in the oesophagus.
- Do we use the same leaky gut healers for the upper gut - the stomach and DIS?
- Dry mouth as a symptom of anxiety and sympathetic dominance, and the importance of relaxation in prompting saliva to bathe the oesophagus.
- Dr SSL and Dr Jacobi use therapies including glutamine, zinc carnosine, n-acetyl glucosamine, gamma oryzanol, quercetin, and demulcents to help heal DIS.
- If a client has slight Barrett’s or erosive esophagitis and is put on lifelong PPIs, is this the appropriate course of action to support?
- How do we slowly wean people off PPIs?
- Sliding hiatal hernia and the possible cause of reflux.
- What is the difference between hiatal hernia syndrome and an actual hiatal hernia?
- Advanced diabetes and issues related to autonomic neuropathy, such as silent reflux.
- Laryngopharyngeal reflux, the typical symptoms to look out for, and conditions it is linked to.
- Enlarged tonsils and the connection to laryngopharyngeal reflux.
- How do we test for low stomach acid?
- Riddler’s reflex point for stomach acid.
- Pectoralis major test for hypochlorhydria.
- Heidelberg test.
- Bile Reflux - what causes it?
- Dysplasia and cancer of the lower oesophagus and the theory linking these conditions to duodenal gastroesophageal reflux.
- What treatment can we do for Bile Reflux?
- The importance of endorphins and enkephalins in the contraction of the sphincters in the body.
- Chapman’s reflex point to improve the tone of the pylorus (taught by Dr SSL in the GI practicum in November)
- Nutrients to help to heal Barrett’s and prevent cancer include selenium, turmeric, green tea catechins, anthocyanidins (found in berries and colourful fruits and vegetables).
- Top causes of reflux to pay attention to besides SIBO:
- Hiatal hernia
- Hiatal hernia syndrome
- Pancreatic insufficiency
- Spasmodic diaphragm
- Anxiety, or conditions that decrease client’s saliva or makes saliva more acidic (eg sjogren’s, elderly)
- Digestive Support for lack of saliva production
- Use zanthoxylum (prickly ash) - 1-2 drops on the tongue, and/or bitters as a digestive stimulant.
- Pilocarpine lozenges
- What is Dr SSL’s opinion on methane and PPI use - being there there is potential for PPI users to have less methane output, and conversely for Hydrochloric Acid (HCl) users to have increased methane production.
- What is the appropriate dose of HCl for patients and should we use capsules or tablets?
- The combination use of bitters plus HCl.
- Rebound hyperacidity - why can it occur after taking PPIs?
- Buteyko breathing for upper digestive symptoms.
Resources
- GI Practicum in Australia on 10th-11th of November 2018
- Reserve your spot
- Healing Leaky Gut, stomach, and DIS
- Dr SSL and Dr Jacobi use therapies including glutamine, zinc carnosine, n-acetyl glucosamine, gamma oryzanol, quercetin, and demulcents.
- Dr Steven Sandberg-Lewis
- Medical textbook - Functional Gastroenterology: Assessing and Addressing the Causes of Functional Gastrointestinal Disorders by Dr Steven Sandberg-Lewis
- Mim Beim
- Buteyko breathing for upper digestive symptoms
In this episode, Dr Nirala Jacobi is in conversation with Heidi Turner about the SIBO Histamine Bi-Phasic Diet and SIBO treatment.
Heidi is a medical nutrition therapist at the Seattle Arthritis Clinic at Northwest Hospital UW Medicine in Seattle, Washington. She counsels those with autoimmune, inflammatory, and degenerative diseases in an effort to decrease their pain through dietary change. She specialises in food intolerances, SIBO, mast cell activation syndrome, histamine intolerance and natural food chemical sensitivities.
Topics discussed include:
- The release of the SIBO Histamine Bi-Phasic Diet (available for free to practitioners) in July 2018.
- Histamine intolerance and what Heidi sees in her practice.
- Why has the Biphasic Diet for Histamine Intolerance been created?
- The SIBO Inflammation relationship to compromised diamine oxidase (DAO) and the impact on patient histamine levels.
- Symptoms of high histamine.
- The issue with low FODMAP diets in relationship to histamine.
- Histamine-containing foods versus histamine liberating foods.
- Foods high in histamine.
- How histamine levels increase in food.
- Which histamine liberating foods are the most problematic?
- How to reintroduce histamine foods and histamine liberators into the diet.
- Patient reactivity to treatment and how to tailor.
- Therapeutic diet timeline.
- Where does the Biphasic Histamine Diet fit into SIBO treatment?
- Decreasing high histamine load rather than eliminating all high histamine foods all the time.
- Heidi’s experience in using the Biphasic Diet for Histamine Intolerance.
Resources
- Heidi Turner - available for in person and digital appointments.
- Food Logic
- In person clinical consultations available at The Seattle Arthritis Clinic
- Upcoming LIVE webinar to be co-presented by Dr Nirala Jacobi and Heidi Turner on the Biphasic Diet for Histamine Intolerance as a therapeutic tool:
- How to implement the diet properly
- How to move out of the diet
- Webinar session times with LIVE Q & A afterwards
- Live session - Thursday, July 12th, 2018 in America
- Live session - Friday, July 13th, 2018 in Australia
- Digital copy post-event available on com
- Dr Nirala Jacobi’s 2018 Biphasic Diet
- Join The SIBO Doctor Practitioner forum on Facebook to connect with other practitioners and to be part of the conversation.
- The SIBO Specific Diet from Dr Allison Siebecker
In today’s episode, Dr Nirala Jacobi welcomes back Dr Jason Hawrelak, to talk about Microbiome Restoration.
Dr Hawrelak is a researcher, educator, naturopath, and nutritionist with over 16 years of clinical experience. He also practices at Gould’s Natural Medicine - a 135-year-old natural medicine apothecary and clinic in Hobart, Tasmania, Australia.
Dr Hawrelak completed his PhD examining the capacity of probiotics, prebiotics, and herbal medicines to modify the gastrointestinal tract microbiota. He is the senior lecturer in Complementary and Alternative Medicines at the University of Tasmania’s School of Medicine where he coordinates the evidence-based complementary medicines programs. Dr Hawrelak also teaches the gastrointestinal imbalances unit, within the Masters of Science and Human Nutrition, and Functional Medicine Program at the University of Western States, in Portland, Oregon.
Topics discussed include:
- The SIBO Doctor courses
- Microbiome Restoration - coming soon
- Regrowing vs killing in the microbiome.
- Colonic collateral when we are dealing with SIBO, and the necessity to restore the colonic ecosystem as part of the SIBO treatment.
- How do we learn to interpret the DNA readings and PCR reports?
- The SIBO Doctor Microbiome Restoration course
- A discussion of the modules offered in the Microbiome Restoration course
- Module 1 - Testing
- The difference between different labs
- Culturing vs DNA techniques
- Assessment, Interpretation, and Diagnosis
- Module 2 - Beneficial Bacteria, including
- Akkermansia
- Faecalibacterium prausnitzii
- Butyrate-producing microbes
- Hydrogen sulfide gas producers
- Module 3 - Pathobionts
- The good, the bad, the ugly
- Hydrogen sulfide producers
- Methanobrevibacter smithii
- coli
- Bacteroides
- Triple antibiotic therapy (for conditions such as H. Pylori and Blastocystis Hominis) and the impact on the colonic ecosystem balance of symbionts and pathobionts.
- Dietary changes vs probiotic supplements to elicit change in the gut microbiome.
- The complications between advising prebiotic nutrition for optimising microbiome restoration, whilst clients are on therapeutic diets such as the Low FODMAP diet - how to reconcile?
- Hydrogen sulfide breath testing - coming soon.
- High-fat content diets in SIBO, and how this can eventually feed hydrogen sulfide producing bacteria.
- Symptoms such as food reactivity and visceral sensitivity as a consequence of dietary choices in SIBO treatment, in regards to hydrogen sulfide producing bacterial blooms.
- The therapeutic benefits of Soy Isoflavones in relation to Methane and Hydrogen Sulfide producing SIBO patients.
- Equol producers - patients who have bacteria that convert soy isoflavones into the bioactive component, Equol.
- Adlercreutzia levels in people who eat soy products as a long-term dietary choice.
- Is there a connection between histamine intolerance, salicylate intolerance, and oxalate intolerance and microbiome disturbances?
- Post SIBO treatment food sensitivities - the colonic microflora patterns to observe.
- Hydrogen sulfide gas and how it causes visceral sensitivity, gut leakiness, and inflammation in the nerves.
- Dietary changes with people with sensitivities - a reiteration of start low, go slow.
- Is there any clinical significance to oxalobacter formigenes being elevated?
- What is the dietary impact of the extinction of oxalobacter formigenes?
- Testing levels of Proteobacteria to uncover the innate endotoxin load (proteobacteria - gram-negative bacteria that secrete proinflammatory endotoxins).
- The systemic repercussions of endotoxemia - leaky blood-brain barrier, gut damage, insulin sensitivity impacts, systemic inflammation, Alzheimer's, anxiety and depression links.
- Endotoxin (also known as Lipopolysaccharides - LPS) absorption and high-fat
- How do different Phyla respond to different diets?
- Potential outcomes of the ketogenic diet depending on the dietary nuances - decreased microflora diversity, increased hydrogen sulfide gas-producing bacteria, and increased numbers of proteobacteria.
- Akkermansia and constipation - why are these often seen together?
- Gut inflammation and mucus tend to increase Akkermansia if it is there - it is a mucin eater.
- Gut markers of inflammation, such as calprotectin.
- The vocabulary to use around probiotics - not re-seeding, but rather restoring.
- The importance of lactic and acetic acid production adjusting the pH of our microbiome to be hospitable to beneficial bacteria.
- D-Lactate considerations.
- Biogaia effectively reducing methane production, and also being used alongside proton pump inhibitors (PPIs) to prevent the development of SIBO.
- PPIs - when to use and when not to - listen to Dr Steven Sandberg-Lewis’ podcast on SIBO and Functional GIT Exam Skills.
- Plantarum LP8 is being used in research to decrease Desulfovibrio, increase butyrate and bifidobacterium - can we use other strains of L. Plantarum to elicit similar changes?
- Plantarum strains to use in gut rehabilitation.
- Reuterin production.
- Dr Hawrelak’s antimicrobial and dietary recommendations for treating Desulfovibrio.
- Module 1 - Testing
Resources
Dr Hawrelak
- Probiotic Advisor
- Gould’s Natural Medicine
The SIBO Doctor Microbiome Restoration Course with Dr Jason Hawrelak [Opens 13 June]
- Sign Up for the Course and Live Q & A with Dr Hawrelak
The SIBO Conference New Orleans - speakers mentioned
- Dr Richard McCallum
- Dr Matthew Bohm
Labs mentioned
- Ubiome - microbiome DNA testing
- Genova
Dr Satish Rao
- SIBO and comorbid SIFO
- D-Lactic Acidosis researcher
Dr Steven Sandberg-Lewis
- Dr Steven Sandberg-Lewis’ podcast on SIBO and Functional GIT Exam Skills
In today’s episode, Dr Nirala Jacobi is in conversation with Kayle Sandberg-Lewis. Kayle recently gave a lecture at the New Orleans SIBO conference on traumatic brain injuries (TBI) and SIBO.
Kayle holds a master’s degree in Behavioral Medicine and has a private practice specializing in acquired brain injuries, anxiety and stress-related disorders. In recent years, she has been exploring the link between brain injuries and gastrointestinal disorders.
Board-certified by the Biofeedback Certification International Alliance as a Neurofeedback Practitioner, she is also trained in peripheral biofeedback. Kayle has several tools at her disposal to help the disordered brain calm itself and function more optimally thereby leading to improved vagal tone.
Kayle serves as adjunct faculty at the National University of Natural Medicine where she created the Applied Psychophysiology track in the Master of Science in Integrative Mental Health.
Topics discussed include:
- How Kayle entered the traumatic brain injury field.
- SIBO, the migrating motor complex, and how TBI can impact this.
- Differentiating parasympathetic and sympathetic nervous system dominance.
- The risks of sympathetic dominance to the digestive system.
- What common injuries are actually classed as TBIs, and how might this contribute to gastrointestinal health?
- The cumulative effect of minor head injuries.
In today’s episode, Dr Nirala Jacobi is in conversation with gastroenterology specialist, Dr Eric Yarnell.
Dr Yarnell graduated from Bastyr University in 1996. He served as a senior and associate editor of the Journal of Naturopathic Medicine, he was a founding member and former president of Botanical Medicine Academy in Seattle, and he is also the president of Heron Botanicals - a herbal pharmacy providing hand-crafted whole plant extracts exclusively to healthcare providers, he is on the editorial board of the International Journal of Naturopathic Medicine, and is the author of numerous texts and articles. Dr Yarnell wrote the Natural Approach to Gastroenterology, which Dr Jacobi often uses as a clinical reference, and he is also a urology and men’s health specialist.
UPDATE!
New Event!
Functional Gastroenterology Practicum with Dr Steven Sandberg-Lewis and Dr Nirala Jacobi, The SIBO Doctor
Registration Now Open
Limited to 100 Seats.
Early Bird Available.
10-11 November 2018
Tweed Heads, NSW Australia
Dr Nirala Jacobi is in conversation with Dr Steven Sandberg-Lewis. Dr Sandberg-Lewis is a highly regarded and well known naturopathic physician. He has been a professor at the National University of Naturopathic Medicine (NUNM) since 1985, in Portland, Oregon. Dr Sandberg-Lewis has a part-time clinical practice and is the author of several Townsend Letter award-winning articles, and of the medical textbook ‘Functional Gastroenterology, Assessing and Addressing the Causes of Functional Digestive Disorders’. He has also been named one of the Top Docs in Portland Oregon in 2014.
Topics discussed include:
- How did Dr Steven Sandberg-Lewis (Dr SSL) first learn about SIBO?
- Gastrointestinal conditions with underlying connections to SIBO, such as Nonalcoholic Steatohepatitis (NASH), and Crohn’s Disease.
- EXCLUSIVE EVENT
- November 7th - 8th, 2018 in Australia (Gold Coast TBA)
- 2 Day Functional Gastroenterology Physical Exam workshop, in person, with Dr SSL.
- thesibodoctor.com for more information
- 100 participants only
- What else can we expect from the Functional Gastroenterology Physical Exam workshop?
- Reflex point assessment
- Combination techniques
- Secretion points
- Bennett’s points on the cranium and abdomen
- How to learn if the ileocecal valve is open or closed
- Riddler’s points
- Physical exam for gastroenterology - how to assess your patients.
- Visceral techniques such as manual correction of hiatal hernias.
- The prevalence of hiatal hernias in different populations and what it can cause, e.g. reflux, anxiety, constipation issues, diaphragmatic issues.
- What is the difference between a true sliding hiatal hernia and hiatal hernia syndrome?
- What symptoms can be expected with sliding hiatal hernia, and how does it relate to SIBO?
- Who first developed this technique?
- Emotional Freedom Technique (EFT)
- Kinesiology in relationship to Functional Gastroenterology Physical Assessment
- Quantum Reflex Analysis use in the clinical setting.
- Manual corrections of the digestive tract
- Ileocecal valve manoeuvre as related to SIBO.
- Ehlers-Danlos Syndrome and the hypotonic ileocecal valve.
- Reasons for tenderness of the ileocecal valve on physical exam.
- Dr SSL’s clinical experience of ileocecal valve corrections.
- Hiatal hernias and the link to arrhythmias.
- Ileocecal valve tone and the relationship to adrenal function.
- Dr Jacobi’s advice for documented hiatal hernia patients
- 500mL of water in the morning on an empty stomach, then do 20-30 heel drops. The weight of the water will pull the stomach back down.
- Exercises to do after the hiatal adjustment to assist visceral compliance ongoingly.
- The link between the client’s emotional body and their physical conditions, and how to integrate this into a clinical setting with the physical
- Neurofeedback - the importance of points Fp1 and Fp2.
- The link between constipation, hiatal hernia, and anxiety.
- Neuro-Emotional Technique (NET) for emotional clearing.
Resources
- Dr Steven Sandberg-Lewis
- Medical textbook Functional Gastroenterology, Assessing and Addressing the Causes of Functional Digestive Disorders by Dr Steven Sandberg-Lewis
- EXCLUSIVE EVENT
- November 7th - 8th, 2018 in Australia (Gold Coast TBA)
- 2 Day Functional Gastroenterology Physical Exam workshop, in person, with Dr SSL.
- thesibodoctor.com for more information
- 100 participants only
- Dr Mark Pimentel
- Dr Allison Siebecker
- Quantum Reflex Analysis
- Dr Jacobi’s advice for documented hiatal hernia patients
- 500mL of water in the morning on an empty stomach, then do 20-30 heel drops. The weight of the water will pull the stomach back down.
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Dr Nirala Jacobi is in conversation with Dr Lela Altman on the topic of the Elemental Diet. Dr Altman presented at the 2017 SIBO Symposium, and in 2018 at The Gastroenterology Association for Naturopathic Physicians, on the topic of the Elemental Diet.
Dr Altman is a Naturopathic Doctor, she has a private practice and also lectures at Bastyr University in Seattle. Dr Altman is also an Acupuncturist. Her interests include gastrointestinal disorders, east asian medicine, diabetes, and cardiovascular disease.
Topics discussed include
- How did Dr Altman get into the field of SIBO with a special interest in Elemental Diets?
- The Elemental Diet is a highly effective standalone antimicrobial treatment, on par with conventional antibiotics or herbal antimicrobials.
- What are the components of the Elemental Diet? What makes it different from medical food replacement products such as Mediclear or powders that aim to heal the gut?
- Proteins are in the form of amino acids only, and there are no other food products in the formula. The nutrients are predigested - you do not need to break anything down.
- Fats in the form of oil, medium chain triglycerides (MCTs).
- Carbohydrate component is either dextrose or maltodextrin.
- Starches may be included.
- Essential vitamins and minerals.
- No fibre.
- Contraindications for the Elemental Diet include
- A history of disordered eating
- Underweight patients (however patients can gain weight on the Elemental Diet due to ease of absorption of nutrients)
- Caution in diabetes due to higher simple carbohydrate and sugar content.
- Caution for known fungal overgrowth or signs or symptoms. If using, use in combination with antifungal treatment - Dr Jacobi always uses an antifungal with the Elemental Diet.
- How can people get the Elemental Diet for their patients?
- Vivonex - Nestle product (not recommended)
- Integrative Therapeutics Physicians’ Elemental Diet
- Dr Allison Siebecker’s homemade Elemental Diet
- Possible complications encountered with prescription of the Elemental Diet.
- Blood sugar dysregulation
- Weight loss
- Intolerable flavour
- Nausea
- Diarrhoea
- Die off reactions
- Constipation
- Abdominal pain
- What happens for 2 versus 3 weeks for patients on the Elemental Diet?
- 80% effective after 2 weeks
- 85% effective after 3 weeks
- No more effective for 4 weeks
- Protocol
- Elemental Diet shakes - 6 per day, or daily amount divided up to have less day every hour.
- Drinks allowed - water, (sometimes) dilute black coffee or black tea.
- SIBO testing patient with same day breath test - if still positive, continue for one more week, if negative, transition off the Elemental Diet.
Transitioning off the Elemental Diet
General
- Keep using some of the Elemental Diet shakes for calories as patient transitions.
- Consider using Elemental Diet as the elimination phase of an Elimination Challenge Diet (eliminate all high allergenic foods for 2 weeks and then reintroduce one every 3 days, if tolerated add back in, if not tolerated keep it out)
Day 1
- Slow introduction of foods starting with broths (be aware that some SIBO clients do not do well with cartilage bones due to the high histamine in glycosaminoglycans. If this is the case, use only marrow bones or meat broth).
- Start patients with Low FODMAP diet for approx 3 days, well cooked vegetables, avoiding raw foods.
- If candida suspected, avoid simple carbohydrates.
Day 2
- Continue with well-cooked Low FODMAP vegetables and broth.
- Congee addition (if no yeast overgrowth) - rice soup with chicken / vegetables.
- Add cooked meats, fish, eggs, grains.
Day 3
- Transition to a simple Low FODMAP diet or Dr Jacobi’s Bi-Phasic Diet
If SIBO breath test is negative start challenging the Low FODMAP diet as described with Elimination Diet Challenge above.
- Same day retesting available in Australia with com
- Notify the lab before sending the test for fast-tracking
- Overnight the test back to com
- What are common symptoms that are usually no cause for alarm?
- Constipation (due to no fibre intake)
- Bowel movements can change largely - client is not eating enough food to pass on a regular basis.
- Great therapeutics include magnesium, herbal laxatives, suppositories, enemas.
- Nausea
- Can start within first couple of days and usually then goes away. Solution is to dilute formula a bit more if you can.
- Can be due to vitamins and supplements taken in addition to Elemental Diet. Recommendation to discontinue non-essential supplements.
- If using Dr Siebecker’s Formula, switch to the lower fat higher carb option, as the high fat option can cause a bit more nausea.
- Bowel changes
- May notice passing stools of dry grey powder - if formula used is powder.
- Diarrhoea - could be a reaction to something in the formula (look to corn oil, soy oil). Treat for dehydration - keep them hydrated and advise sipping formula slowly throughout the day (which also assists blood sugar regulation).
- What to do to improve flavour of the homemade Elemental Diet? Options may include:
- Stevia
- Flavoured magnesium powder (use caution here with appropriate quantity).
- Extract drops, such as almond, peppermint etc.
- Blend with ice.
- Use a cup with a straw so as to not smell it.
- Do not let it sit out for more than the time that it is being consumed.
- The Half Elemental Diet
- Not used for SIBO treatment
- Can be used for providing bowel rest for anyone in an inflammatory bowel flare.
- Can be used to increase caloric intake for someone who is requiring hypoallergenic caloric supplementation (a few days to a week’s duration) - used as a caloric and nutritional booster for those with extreme food sensitivities.
- Additions
- If client is getting hungry on having the Elemental Diet - add coconut or MCT oil to formula to increase calories.
- Dr Altman’s opinion on using the Elemental Diet in the daytime and eating meat at night?
- The difference between meat protein and elemental diet protein - the latter is in a free form and are therefore rapidly absorbed and not much reaches the colon.
- Initiate prokinetics immediately at completion of Elemental Diet to inhibit regrowth of SIBO.
- Consider low dose antimicrobial herbs at completion of Elemental Diet to inhibit regrowth.
- Consider that stomach acid is killing most of the bacteria that we ingest - support this if necessary.
- Consider the underlying root cause of client’s initial SIBO and keep that managed to prevent relapse.
- Dr Altman’s clinical pearls re The Elemental Diet.
- The cost of a 2-week course of The Elemental Diet
- Example at 6 shakes per day of Physicians’ Elemental Diet it comes to approximately $650 USD.
- No need for hunger - patients can have as many shakes as they want.
- Constipation (due to no fibre intake)
Resources
- Dr Lela Altman
- Dr Altman’s talk Elemental Diet Webinar with CME available.
- Bastyr University Digestive Wellness Clinic in Seattle, Washington.
- Private Practice in the Bastyr Centre for Natural Health.
- Dr Pimentel
- Elemental Diet options
- Integrative Therapeutics
- Physicians’ Elemental Diet
- Dr Allison Siebecker’s homemade Elemental Diet
- Vivonex - Nestle (not recommended)
- Integrative Therapeutics
- Elemental Diet components
- Jo Mar Labs Black Label 21 Blend for amino acids
- Same day retesting available in Australia with com
- Notify the lab before sending the test for fast-tracking
- Overnight the test back to com
- Dr Jacobi’s Bi-Phasic Diet
- Dr Allison Siebecker’s SIBO Specific Diet
- Specific Carbohydrate Diet (SCD)
In today’s episode Dr Nirala Jacobi is in conversation with Dr Ilana Gurevich on the topic of inflammatory bowel disease (IBD) and small intestinal bacterial overgrowth (SIBO). Dr Gurevich is a naturopathic physician and acupuncturist who graduated from the National University of Natural Medicine in 2007 and 2008. She is currently co-owner of two large integrative medical clinics, one in northwest Portland and one in northeast Portland. Dr Gurevich also runs a very busy private practice specializing in treating inflammatory bowel disease as well as irritable bowel syndrome (IBS), SIBO and functional digestive disorders.
She lectures extensively and teaches about both conventional and natural treatments for inflammatory bowel disease as well as SIBO. She is one of the foremost experts on the intersection of IBD and IBS and how treating one resolves the other. Dr. Gurevich also acts as a mentor in the naturopathic community educating about GI disorders. She supervises residents and consults with physicians about their most difficult GI cases.
Dr. Gurevich was nominated as one of Portland Top Docs by the Portland Monthly in both 2014 and 2016.
Topics discussed include:
- How did Dr Gurevich come to specialise in IBD?
- How acute flares of IBD can be related to SIBO.
- In relation to small bowel Crohn’s and small bowel Ulcerative Colitis.
- Testing Dr Gurevich uses for IBD
- Fecal calprotectin (before getting colonoscopy/gastroscopy)
- Stool collection to test for leukocytes within the small bowel, giving an accurate sense for how much inflammation is in the intestine.
- Useful for Crohn’s and Colitis.
- Colonoscopy
- Gastroscopy
- Comprehensive digestive stool analysis (CDSA) - Doctor’s Data
- GI Health Panel - DiagnosTechs
- What kind of flora is in there?
- Are there parasites, yeast, and assessing food breakdown?
- ParaWellness Research - parasitologist
- Fecal calprotectin (before getting colonoscopy/gastroscopy)
- Dr Jacobi uses Genova GI Effects for the PCR testing and microbiome assessment for anaerobes that could not previously be cultured out.
- Carroll Food Intolerance Testing
- Dr Gurevich’s view of food allergy testing for IBD patients.
- Microscopic colitis - what is it? What is its main symptom?
- Lymphocytic
- Collagenous
- Parallels with Coeliac Disease.
- Clinical pearl - if client is having greater than 10 bowel movements a day look into microscopic colitis and other possible conditions.
- How to use Budesonide (steroid) for a 3-5 month window, to address microscopic inflammation. Budesonide not as systemic as prednisone, and can be used concurrently to naturopathic care to continue to heal the intestine whilst client tapers off the Budesonide.
- Does microscopic colitis also show elevated fecal calprotectin?
- Diagnosing microscopic colitis with colonoscopy or sigmoidoscopy.
- How is ileocecal valve pressure associated with SIBO?
- IBD recalcitrant population and why they are more susceptible to SIBO.
- Bacterial translocation from the large bowel flora into the small bowel and how ileocecal valve scarring increases SIBO susceptibility.
- How to assess ileocecal valve pressure.
- Colonoscopy (although not included with a standard colonoscopy).
- 20% of people are found to have open ileocecal valves. Why?
- How else is the ileocecal valve scarred?
- Upcoming workshop in Australia - November 2018 - Dr Steven Sandberg-Lewis on physical exam skills of functional digestive disorders - how to free a stuck open or stuck closed ileocecal valve, the hiatal hernia manoeuvre, and a plethora of other techniques.
- Lower esophageal sphincter is part of the diaphragm - valvular relaxation treated with Buteyko Breathing.
- Does Dr Gurevich see much hydrogen sulfide dominant SIBO with IBD patients?
- Various assessment techniques for the complex hydrogen sulfide dominant SIBO.
- uBiome
- Genova GI Effects
- Flatlining on a SIBO breath test
- The use of biologic agents in IBD as TNF Alpha inhibitors e.g. Remicade as an IV infusion, Humira as a subcutaneous injection, Cimzia (the only one safe in pregnancy).
- Biosimilars - generic biologics - about to be launched in the States.
- Upcoming course with Dr Gurevich for the natural treatment of IBD in 2018 via The SIBO Doctor Education Centre.
- The body has the potential to treat the biologic agent in the same way as it treats the intestine if the person has IBD - practitioners MUST fully educate the client of the risks of going on or off the biologic agent.
- What are the increased risks with use of biologic agents?
- Acute flare treatments that Dr Gurevich uses for Crohn’s, Ulcerative Colitis, or both.
- Rectal ozone - extremely anti-inflammatory and extremely fast acting.
- Elemental diet - as effective as steroids.
- Specific carbohydrate diet - SCD Intro included.
- If no improvement then movement towards steroids to treat acutely.
- Maintenance treatments that Dr Gurevich uses for Crohn’s, Ulcerative Colitis, or both.
- Carroll test for dietary triggers
- SIBO test for underlying cause
- ParaWellness test for underlying cause
- GI Lumen healing - seacure hydrolysed white fish protein, high dose resveratrol, glutamine, CBD and THC, colostrum, Physica GALT fortifier (Dr Gurevich’s new favourite).
- Always focus on digestive support - enzymes, hydrochloric acid, probiotics (e.g. saccharomyces boulardii for diarrhoea regulation), apple cider vinegar.
- IV nutrition to help clients who have been ill for a very long time.
- Do parasites play a role in IBD?
- Dr Gurevich’s experience with butyric acid enemas.
- Dr Gurevich’s position on conventional antibiotics for IBD patients.
Resources
- Dr Ilana Gurevich
- Portland, Oregon
- Kwan Yin Healing Arts Centre
- Phone consults available
- Dr Mark Pimentel
- Mim Beim - Buteyko Breathing Australia
- Buteyko Clinic International
- Greg Nigh - Hydrogen Sulfide Expert
- Dr Jason Hawrelak - Microbiome Expert and Founder of clinical tool - Probiotic Advisor
- Dr Mona Morstein - Diabetes expert
- Physica GALT fortifier
Testing discussed
- Fecal calprotectin
- Comprehensive digestive stool analysis (CDSA) - Doctor’s Data
- GI Health Panel - DiagnosTechs
- ParaWellness Research
- Genova GI Effects
- Carroll Food Intolerance Testing
- uBiome
Upcoming courses (2018)
- November 2018, Australia - Dr Steven Sandberg-Lewis on physical exam skills of functional digestive disorders via the SIBO Doctor Education Centre.
- 2018, Digital - Dr Gurevich for the natural treatment of IBD via the SIBO Doctor Education Centre.
Dr Greg Nigh co-founded the Immersion Health Centre in 2014 after completing the Naturopathic Doctor program, and the Master of Science and Oriental Medicine Program. During his early years of work, he developed his interest and passion for researching and implementing alternative cancer therapies. Dr Nigh has spoken several times at the annual convention of the American Association of Naturopathic Physicians and the National Conference of the Oncology Association of Naturopathic Physicians on cancer cell metabolism. Dr Nigh is a prolific reader, researcher, and writer and has also contributed a chapter to the upcoming two-volume Foundations of Naturopathic Medicine textbook.
Recently Dr Nigh and Dr Jacobi both presented on the SIBO SOS Summit. Dr Jacobi loved Dr Nigh’s talk on hydrogen sulfide and has invited him on the show to discuss sulfur metabolism and his unique ideas about hydrogen sulfide and sulfur imbalances.
Topics discussed include:
- How did Dr Nigh come to specialise in sulfur?
- All about sulfur metabolism.
- Sulfur chelates so well that it can get bound up in our bodies with toxic things.
- The GAPS diet, how it has high sulfur content, and why some patients may not feel well on the GAPS diet.
- Sulfur issues as the ‘canary in the coalmine’ of toxicity issues in general.
- How the demand for sulfur is higher due to increased exposure to pollutants in modern life, and the impact this has on sulfur binding throughout the body and not just in phase 2 liver detoxification.
- How does endogenous sulfur processing, and sulfur production and reduction by certain gut bacteria, connect?
- Sulfur exposure is all dietary, and is metabolised to sulfate in the body.
- Sulfate is required in the body in a constant supply, and sometimes the metabolism of sulfur to sulfate is hindered.
- Heparan sulfate - every surface is in the body is lined with this.
- Elements that sulfur is used to build in the body.
- The primary, and alternative, pathway/s of sulfate production.
- Cystathionine beta synthase (CBS) pathway, what it generates (hydrogen sulfide)
- PAPS - the activated form of sulfate, and the pathways the body uses to get it.
- When people are reactive to sulfur or sulfur containing foods or thiols, they are not having an efficient process that ends up in PAPS - what are they reacting to in the pathway?
- If people cannot get the end product PAPS, then people can overgrow the sulfur fixing bacteria so that they produce higher levels of hydrogen sulfide and sulfide, which can be directly oxidised into sulfate by the mitochondria in the body.
- Dr Nigh’s view is that the overgrowth of hydrogen sulfide bacteria can be seen as an adaptive overgrowth.
- How to reduce desulfovibrio with diet.
- Reasons why sulfate production can be shut down, one being glyphosate - a direct hit to sulfate production in the body, chelation of minerals that are needed for sulfur production, interference of specific amino acids involved in the sulfur cycle, and more.
- The impact of glyphosate on the sulfur production in the body is profound.
- Glyphosate - a toxic herbicide, the active ingredient in roundup.
- Glyphosate chelates molybdenum.
- We need tiny amounts of it, and if we only need tiny amounts it does not take much to chelate and use it up.
- Dr Nigh’s view on testing.
- Patient symptom red flags that point to sulfur issues, for example:
- Hydrogen sulfide is a vasodilator, so has links to orthostatic hypotension.
- Any gut issues - warrants sulfur issue suspicion.
- Alcohol sensitivity
- Red, hot presentation
- Brain fog
- Histamine and sulfur overlaps.
- Histamine issue symptoms.
- Dr Nigh’s protocols for enhancing sulfate production from sulfide.
- Taking the patient off sulfur foods for a week then gradual reintroduction.
- Detoxification protocols
- Infrared sauna
- Molybdenum supplementation
- Biotics Mo-Zyme Forte - food based tablet based on sprouted lentils
- 150mcg molybdenum
- Tablet chewed 2 times per day
- For those with bloating or gut issues
- Biotics
- Bio HPF - bismuth, demulcents, and others.
- Bismuth reduces hydrogen sulfide production in the gut.
- Butyrate
- The most underrated gut nutrient that there is.
- Biotics
- Butyric-Cal-Mag
- Apax EnteroVite
- Digestive enzyme
- Hydroxocobalamin injections or sublingually to lower hydrogen sulfide in the blood.
- Zinc acetate as a binder for hydrogen sulfide
- Glyphosate strongly chelates zinc.
- Detox support, coffee enemas, colonics, epsom salt baths (magnesium sulfate) - increasing sulfate transdermally, adrenal support if indicated
- Epsom salts (4 cups per bath) - a way to get sulfate in without the reactivity of digestion.
- Sensory deprivation tank option.
- Dr Yarnell’s low sulfur diet
- Thiols and Dr Nigh’s opinion on their reactivity for people.
- Red meat is the highest dietary source of sulfur and yet does not seem to have many people reacting to it, whereas garlic does. Why is this?
- Foods to watch - eggs, onion, kale, garlic, cabbage, brussel sprouts, cabbage, brassica family.
- Kale accumulates the heavy metal thallium (from waste-water used for crops).
- Do Allicin extracts still elicit issues in people with sulfur issues?
- Highly important to include any sulfur food items that are tolerated for the sulfur content (required by body).
- Dr Nigh’s sulfur protocol and his success with SIBO patients.
- What is the connection between Dr Nigh’s success with methane dominant SIBO clients and the sulfur protocol?
- How might glyphosate toxicity play into this?
- Methanobrevibacter smithii - not a pathogen, why?
- SIBO bacteria - why do we only grow certain bacteria?
- Dr Nigh’s sulfur metabolism nuggets.
Resources
- Dr Greg Nigh
- Immersion Health Portland, Oregon
- drnigh@immersionhealthpdx.com
- SIBO SOS Summit
- Dr Yarnell
- Naturopathic Foundations of Gastrointestinal Diseases?
- Foundations of Naturopathic Medicine
- Biotics Research
- Mo-Zyme Forte
- Bio HPF
- Apax EnteroVite
In today’s episode, Dr Nirala Jacobi is in conversation with Dr Carrie Jones. Dr Jones is a Naturopathic Doctor and hormone specialist from Portland. She has completed a two-year residency in advanced women’s health, gynaecology and hormones, and has also completed her Masters of Public Health at the Grand Canyon University. Dr Jones has been the medical director of two large integrative medical clinics in Portland and is currently the medical director of Precision Analytical, a laboratory that offers the DUTCH Profile. She writes for multiple health websites and is featured in a range of health podcasts.
Topics discussed include
- Hormones and their relationship to functional digestive disorders.
- Digestive flares before a woman’s period and why this can occur.
- How gut inflammation can affect hormones - for example by raising cortisol, raising estrogen, raising 5 alpha reductase, lowering dehydroepiandrosterone sulfate (DHEA-S), affecting the absorption of nutrients that comprise hormones.
- How lipopolysaccharides (LPS) and endotoxemia can impair and congest phase 1 and 2 liver detoxification pathways.
- Nutritional cofactors required to support smooth Catechol-O-methyltransferase (COMT) functioning, especially in light of COMT single-nucleotide polymorphisms (SNPs).
- Symptoms of estrogen dominance in men and women.
- Hormone patterns related to a dysfunctional gut microbiome.
- The estrobolome and how it can dictate how much beta-glucuronidase is produced, as well as how much dehydroepiandrosterone (DHEA) is released from the body.
- All about estrogen metabolism, the different metabolites that are produced, which ones are beneficial, and the liver pathways used for processing.
- Which estrogen metabolising pathways have associated cancer risk?
- The role of beta-glucuronidase in disrupting estrogen excretion.
- High toxic load patients and how hormone disruptors affect CYP enzymes and estrogen receptors.
- How can a patient show symptoms of estrogen dominance and yet their hormonal profiles be ok?
- Hint: If proliferative estrogen metabolising pathways favoured.
- When to intervene for hormonal balance when client presents with gastrointestinal issues?
- In light of high levels of beta-glucuronidase.
- How to test for beta-glucuronidase - fecal.
- What can we do about estrogen dominance?
- Support for Phase 1
- Diindolylmethane (DIM) for clients favouring unhealthy 4-OH E1 or 16a-OH E1 pathways.
- Dietary adjustment to include Indole-3-carbinol (I3C) containing vegetables.
- Broccoli sprout powder for sulforaphane (to activate quinone reductase)
- Helps reverse the effects of going down unhealthy 4-OH E1 pathway.
- Glutathione support with N-acetylcysteine (NAC), and liposomal glutathione.
- Support for Phase 2 (COMT support)
- Magnesium
- Methylated B Vitamins
- Methionine
- Choline
- S-Adenosyl-L-Methionine (SAMe)
- Gut treatment
- Calcium D-glucarate to help lower beta-glucuronidase levels.
- Fibrous foods to bind free floating estrogen.
- Note: Broccoli and fibrous products not recommended in phase 1 of SIBO treatment.
- When to use binders in detoxification treatment.
- Progesterone
- Why can people with bloating potentially be progesterone deficient?
- Progesterone cream in second half of the cycle versus vitex supplementation - what age groups are appropriate to each?
- DUTCH testing - what is the difference between all the testing available?
- Saliva tests - free hormones.
- Blood tests - hormones are bound to sex hormone binding globulins or other carrier proteins.
- DUTCH test - free hormones and metabolites.
- Cortisol and cortisone - how to assess beyond an adrenal stress index, the difference between both forms, and why the body may have a pattern of inactivating cortisol into cortisone.
- How to balance cortisol to cortisone ratio?
- The role of licorice (Glycyrrhiza glabra)
- Flatlining cortisol and its role as a marker for chronic infection, its association with an increased risk for cancer, and increased risk for autoimmune issues.
- The cortisol awakening response and how it works with the thymus gland to destroy autoimmune antibodies.
- The link between chronic infections and low cortisol, and how to address.
- All about DHEA and DHEA-S
- Counters stress
- Energy, bone health, neurotransmitter balance, sex drive, muscle development.
- 7-keto DHEA - what is this?
- Supporting DHEA via adrenal support.
- When and when not to test hormone levels.
- Endometriosis and digestive disturbance due to adhesions, inflammation, and excess estrogen.
- New developments in the hormonal testing field.
- IBS symptoms around the period and why this may be.
- The importance of structural alignment for uterine and intestinal health.
- Therapy to address structural alignment - visceral manipulation, pelvic massages, and bodywork.
- Flaxseeds
- Helpful for estrogen dominance
- Raises SHBG (note that flaxseeds preferentially bind testosterone - so care in women who are struggling with testosterone levels)
- Soy
- The role of fermented soy for hormonal balance in menopause.
- Is soy estrogenic, or does it downregulate the proliferative estrogen pathway?
- Dr Carrie Jones’ 2018 hormone education plans for practitioners and patients.
- Support for Phase 1
Resources
- Dr Carrie Jones
- Precision Analytical for Dutch Testing
- A5M conference 2017
- Dr Chris Shade Podcast - detoxification
- Dr Walter Crinnion - environmental medicine
In this episode, Dr Nirala Jacobi is in conversation with SIBO and diabetes expert, Dr. Mona Morstein.
Dr. Mona Morstein has been a naturopathic physician for 29 years. Her private practice, Arizona Integrative Medical Solutions Clinic, is in Tempe, AZ, USA. Her practice has always had a focus on treating gastrointestinal conditions and she was Gastroenterology professor at Southwest College of Naturopathic Medicine for 11 years.
Dr. Morstein has been working seriously with SIBO patients for 5 years and is now considered to be an expert. She has authored the recently published resource ‘Master your Diabetes’, which is the number 1 best selling book on type 2 diabetes on Amazon. Dr Morstein was a speaker on the First and Second SIBO SOS Summit, and is now on the Medical Advisory Board of Quintron Instrument Company, Inc. Dr. Morstein’s innovative and comprehensive Step by Step treatment of SIBO has earned her patients around the world. She has just created a high quality line of SIBO supplements through Priority One Supplements.
Topics discussed in this episode include
- How did Dr Morstein get into SIBO and why did she want to specialise in this topic?
- What is the association between SIBO and Diabetes?
- Insight into A1C
- 7 is considered well controlled, although damage to the human body is cited in the science as when the A1C goes over 5.5.
- What are the four places in the body that cannot produce insulin resistance, and so express the effects of high sugar in the serum? How does this reflect the health of the rest of the body?
- Diabetic neuropathy to the Autonomic Nervous System (ANS), particularly in the gastrointestinal tract (GIT) and how this relates to hypomotility and SIBO.
- How do you specialise treatment to diabetes induced nerve tissue damage in the GIT as compared to other SIBO triggers, such as post-infectious SIBO?
- What to use to treat autonomic diabetic neuropathy in SIBO?
- Acetyl L-carnitine
- Lion’s mane
- Alpha Lipoic acid
- Is diabetic neuropathy reversible?
- Autoimmune vinculin damage to the migrating motor complex (MMC) in the small intestine.
- Lion’s mane - powerful nerve regeneration capacity
- Is there a role for it for regenerating nerves in the small intestine in light of Anti-Vinculin, and Anti-cytolethal Distending Toxin B (CdtB) antibodies?
- The form of Lion’s Mane required - it must be water extracted.
- Dose: 1 capsule bd.
- Using Lion’s mane in conjunction with a prokinetic.
- Patients with a strong history of post-infectious IBS or SIBO get more attention paid to prokinetics than those who may have adhesions causing the restrictions and outflow problems, rather than nerve based causation.
- Diet, diabetes, and SIBO - where to start?
- Low FODMAP
- Bi-Phasic Diet
- Specific carbohydrate diet (SCD) Diet
- Fibre - what fibre, and how to integrate.
- Why to have diabetic patients avoid grains.
- The importance of short chain fatty acid (SCFA) butyrate for colonic cell health, and how to navigate this for diabetic patients in light of no grains.
- Fibre powders.
- Types of fibres for SIBO patients
- Quinoa
- Millet
- Hydrolysed guar gum
- Types of fibres for diabetic patients
- Whole Food fibre from Standard Process - high patient compliance
- Paleo Fibre from Designs for Health
- Microbiome restoration in the large intestine
- Dr Morstein’s specific SIBO protocols for diabetic patients - 8 Essentials
- Diet
- Exercise
- Sleep
- Stress management
- Healing the gut
- Addressing the microbiome
- Environmental detoxification
- Supplementation
- Multivitamin
- Fish Oil
- Diamend - specialty diabetes product
- All about the contents of Dr Morstein’s specialty diabetes product - Diamend (which contains benfotiamine)
- What is Benfotiamine?
- Fat soluble thiamin with positive benefits in neuropathy.
- How does it interfere with glycosylation?
- Maximum dose 450mg/day
- Prevents damage in high glucose areas - protective to those who do not even have neuropathy.
- Dysglycemia not just in diabetic patients
- Tips to manage hypoglycemia in patients who do not have diabetes.
- The role of the adrenals in reactive hypoglycemia
- How to nourish the adrenals and the liver to rectify reactive hypoglycemia
- Chromium, zinc, gymnema sylvestre, liver herbs.
- Glyco-kinetic complex from Integrative Therapeutics Inc
- Other triggers that can drive reactive hypoglycemia?
- Products used for SIBO and Diabetes
- How is berberine beneficial for clients with metabolic syndrome?
- Turns off protein kinase-C
- Reduces insulin resistance, promotes energy use, anti-inflammatory, supports the liver and bile function, reduces cholesterol and triglycerides.
- Present in Diamend
- A caution for berberine use for those with anxiety - impact on monoamine oxidase (MAO) for people with single nucleotide polymorphisms (SNP) in that area.
- What role does the microbiome play in the development of diabetes?
- Could we prevent the development of type 1 diabetes?
- The type 2 diabetes microbiome and the impacts of inflammation, nutrient absorption, production of tumour necrosis factor (TNF), intestinal endotoxins and insulin resistance.
- Dr Morstein’s products developed for SIBO via Priority One Supplements
- SIBO MMC - prokinetic
- SIBOtic
- SIBOzyme
- SIBO rebuild - recovery phase of small intestine once SIBO has been eradicated (contains water extracted Lion’s Mane)
- Zanthoxylum (Prickly Ash)
- Used for dry mouth syndrome
- Motility agent
- Dr Morstein’s top clinical tips for SIBO and Diabetes treatment
- How is berberine beneficial for clients with metabolic syndrome?
Resources
Dr Mona Morstein
- Arizona Integrative Medical Solutions Clinic
- Master your Diabetes by Dr Mona Morstein - Amazon.com
- Contact Dr Mona Morstein
- Dr Morstein’s SIBO and Diabetes supplement line through Priority One Supplements
- Diamend
- Diabetic supplement
- Contains benfodtiamine
- Products developed for SIBO via Priority One Supplements
- SIBO MMC - prokinetic
- SIBOtic
- SIBOzyme
- SIBO rebuild - recovery phase of small intestine once SIBO has been eradicated (contains water extracted Lion’s Mane)
- Dr Allison Siebecker - com
- First and Second SIBO SOS Summit
- Dr Nirala Jacobi’s Bi-Phasic Diet
- Fibre for diabetic patients
- Whole Food fibre from Standard Process - high patient compliance
- Paleo Fibre from Designs for Health
- Fibre for SIBO patients
- Hydrolysed guar gum
- Reactive hypoglycemia liver and adrenal nourishing complex
- Glyco-kinetic complex from Integrative Therapeutics Inc
- Walter Crinnion on environmental toxicity
- Diamend
In this episode Dr Nirala Jacobi is in conversation with Dr Christopher Shade. Dr Shade is the CEO and founder of Quicksilver Scientific, a lab that specialises in the environmental, biological, and analytical chemistry of mercury and all of its forms, and its interaction with sulphur compounds, particularly glutathione, and its enzyme systems.
Dr Jacobi met Dr Shade at the Bioceuticals Research Symposium in Sydney, 2017, and was riveted by his presentation on detoxification.
Topics discussed in this episode include:
- The liver, gallbladder, and GI connection, and how to align them so as to clear gastrointestinal issues.
- How failure to move bile is at the heart of detox reactions
- Bile as a detergent in the small intestine and how bile can be a core issue in SIBO.
- Bile acid destruction and fat malabsorption in SIBO.
- Emunctories and what this means.
- Drainage areas and how the extracellular space is cleared.
- Metal binder for the GI tract that is far better than chlorella - IMD microsilica
- Toxin conjugates and their interaction with bile salts.
- Phosphatidylcholine (PC), its requirement to fluidise the bile, and choline’s relationship to cholestasis.
- Lipopolysaccharide (LPS) endotoxins from leaky gut (from SIBO) creating inflammation in the hepatocytes and the flow on effects from this.
- Phase 3 detoxification - The role of bile flow in lessening detoxification reactions through lowering toxic conjugate buildup in the blood, and instead moving them through the proper elimination channels.
- The importance of addressing emunctories in treating skin conditions.
- How LPS impairs phase 3 in the liver.
- Neurological consequences of leaky gut, SIBO, and of a backfiring liver.
- Neuroinflammation, LPS, and a leaky blood brain barrier.
- Movement of metals into the urinary flow and how it has nothing to do with glomerular filtration rate (GFR), even though this is what is commonly measured for kidney function.
- Organic anion transport peptide’s (OATP) role in bringing toxic conjugates from the blood into the proximal tubular epithelial cells in the kidneys, then the movement of the toxic conjugates into the urinary flow through the MRP2 transporter.
- MRP2 and how LPS and metals can block it.
- How the same things that shut down liver transport of toxic conjugates, can also shut down kidney transport.
- Does LPS affect GFR?
- Active transport of toxins happens in the proximal tubules of the kidney, not in the glomerulus.
- Kidney disfunction and how SIBO can be related to proximal tubule damage in the kidney due to the build up of LPS.
- Proximal tubule function test available - Mercury Tri-Test from Quicksilver Scientific.
- Genetic Single Nuclear Polymorphisms (SNPs) and how the transport protein SNPs are commercially uncharted as yet.
- How inflammation blocks detoxification.
- Chronic infections turning down detoxification.
- Ways to address phase 3 detox.
- Address under-functioning gallbladder with PC, for example.
- Address leaky gut so that toxins dumped into small intestine do not recirculate.
- Strong bitters before meals.
- Take multi-toxin binder (30 minutes after taking bitters) - this is important to do 30 minutes after bitters.
- Dr Nirala Jacobi uses Toxaprevent, but not in SIBO-C patients.
- Dr Shade uses:
- Charcoal
- Clay
- Chitosan
- Metal binder eg. IMD (much stronger than chlorella), Chlorella.
- Acacia gum
- For leaky gut
- Low FODMAPS
- Bifidogenic prebiotic
- Powdered Aloe
- Marshmallow root
- Slippery elm
- Is there a test to assess phase 3 detox function?
- NRF2 upregulators and their role in cellular detoxification, to be implemented AFTER liver and kidney detoxification is streamlined.
- The importance of NRF2 and the effects it has on the body.
- Dr Shade’s universal binder - Ultra Binder
- How to access Dr Shade’s products.
- Dr Shade’s recipe for a self made toxin binder.
- The importance of Myrrh in the bitters
- The bitter detoxifier in ayurvedic medicine, qi and blood mover in chinese and ayurvedic medicine, and strong antimicrobial.
- Cautions with long term myrrh supplementation.
- Other herbals bitters to include:
- Dandelion
- Solidago (Golden Rod)
- Gentian
- Dr Jacobi’s bitters blend
- Dandelion
- Oregon grape
- Gentian
- Baical Skullcap
- Bitters as opening up the bile, tonifying the kidneys, and restoring ileocecal valve function.
- What is the function of bitter receptors on the ovaries?
- If SIBO clients are Hydrogen Sulfide dominant note that the bacteria involved here are bile loving, so any cholagogues will exacerbate the SIBO issue.
- Does charcoal absorb all of your minerals?
- Using charcoal as the primary binder - amounts to take and rationale for diversifying binder portfolio.
- Is mercury stored in biofilm?
- Is it advised to disrupt biofilm, or is it dangerous to do so?
- EDTA as a biofilm breaker.
- Plaques in the vascular system are actually biofilms.
- What mercury testing is offered at Quicksilver Scientific?
- Is it worth testing for mercury toxicity?
- When is it good to test people for mercury toxicity?
- How healing the GI tract can heal the kidneys.
- What is the evil of amalgam fillings?
- Why people with amalgams often have to urinate a lot at night.
- The body has it’s own inbuilt chelating system - glutathione, glutathione-s-transferase, and the transport proteins.
- What are the myths of chelation agents?
- Is lipoic acid a chelator, or is it upregulating the body’s natural chelation system?
- The importance of lining up all the drainage, and lining up all the phases of detoxification.
- Hydrotherapy for the lymphatics.
- The issues in Australia with lead and aluminum - Dr Shade’s recommendation on how to test these areas:
- Nutripath’s Blood Metals Assay
- Excess copper in the presence of low zinc can become synergistically toxic with all toxic metals.
- Whole blood vs intracellular for testing?
- How do you measure intracellular stores?
- Residence time in the blood of different metals.
- Dr Shade’s last pearls of wisdom - start with drainage, then move to mobilisation after levels come down first with good drainage.
Resources
- Quicksilver Scientific
- Dr Shade’s Quicksilver Scientific Youtube channel
- Proximal tubule function test available - Mercury Tri-Test from Quicksilver Scientific.
- Tri-test is available through Nutripath
- Ultra Binder by Quicksilver Scientific for detoxification
- Bitter X by Quicksilver Scientific
- Klinghardt therapy
In this episode, Dr Nirala Jacobi is in conversation with Mim Beim about the effect of the breath on the digestive tract.
Mim has 30 years of naturopathic experience, she has authored books, and is a respected naturopathic voice in the media. Mim has also held lecturing positions at the Australian College of Natural Therapies (ACNT) and has two practices.
Topics discussed include:
- Mim’s story and how she came to Buteyko breathing.
- Physiological effects of Buteyko breathing.
- What actually happens with Buteyko breathing?
- Overbreathing - chronic hyperventilation (breathing more than we metabolically need) and the effect of losing too much carbon dioxide.
- What are the effects of increasing carbon dioxide in the body in miniscule amounts?
- Digestive conditions and the breath.
- How can Buteyko help with irritable bladder, uterine issues, digestive conditions, high blood pressure, peripheral circulation, sleep apnoea, and asthma (among others), and what is the mechanism?
- What is the importance of nose breathing?
- The magical chemical, nitric oxide, and how to produce it with breathing.
- The Bohr Effect
- If carbon dioxide levels are a little higher the result is more oxygen delivery.
- The importance of this in conditions featuring damaged lung tissue.
- The importance of increasing carbon dioxide and resetting respiratory centres in the brain to create new patterns of breathing.
- Buteyko exercises and how they can create permanent changes in physiological responses.
- Age appropriate and condition appropriate Buteyko breathing exercises.
- What improvements and symptomatic relief has Mim seen with Buteyko breathing with SIBO and digestive conditions?
- Nitric oxide improving functioning of sphincters and how this affects the digestive tract.
- What are common signs of dysfunctional breathing?
- Tactics to retrain mouth breathing during sleep and the outcomes of this.
- Nose breathing at night and how this positively and profoundly affects orthodontic development.
- Sleep apnoea and the flow on effects to other conditions in the body, eg diabetes, and heart disease.
- Sympathetic overdrive and Buteyko’s role in helping to retrain trigger happy adrenal glands.
- Diaphragmatic breathing.
- Motility and the parasympathetic nervous system.
- How to know when the parasympathetic is turned on - such as increased salivation, warmth, and decreased anxiety levels.
- Stories of health success with Buteyko Breathing.
- Webinar courses for practitioners who cannot make it to in person trainings.
- Live webinar courses for patients.
- An example of a Buteyko breathing exercise - a live exercise on the SIBO Doctor Podcast with Mim Beim.
- General indication: if the parasympathetic switch takes over 2 minutes to activate, this indicates a heavy tendency to sympathetic dominance.
Resources
- Mim Beim
- Breathing Quiz
- Skype appointments also available.
- Patrick McKeown - Buteyko Educator (in person and online) for practitioners and practitioner locator for patients.
- com
- Oxygen Advantage - Performance training for athletes, November 9-11 2017 in Sydney, Australia.
- Buteyko Breathing Practitioner Training
- November 1st-5th 2017 with Patrick McKeown and Mim Beim in Sydney, Australia
- Rosalba Courtney - osteopath specialising in breathing and training.
In this episode, Dr Nirala Jacobi is in conversation with world class gastroenterologist Dr Lenny Weinstock about Small Intestinal Bacterial Overgrowth (SIBO) and its connection to different conditions in the body.
Dr Weinstock is board certified in gastroenterology and internal medicine, is the president of Specialists in Gastroenterology and the Advanced Endoscopy Centre, he teaches at Barnes Jewish Hospital and is an associate professor of clinical medicine and surgery at Washington University School of Medicine. Dr Weinstock is also a primary investigator at the Sundance Research Centre and has written more than 80 articles, abstracts, editorials, and book chapters. He is passionate about SIBO and its connection to different conditions, such as Restless Leg Syndrome and Rosacea.
Topics discussed in this episode include:
- Dr Weinstock’s approach to SIBO treatment in his Specialists in Gastroenterology Clinic
- Relapse rate after Rifaximin use
- Dr Mark Pimentel has mentioned relapse is hastened by adhesions - Dr Weinstock’s take on this and Dr Weinstock’s experience in his clinic.
- What are some triggers for SIBO?
- Autoimmune Irritable Bowel Syndrome (IBS)
- Post infectious IBS - damage to the migrating motor complex via an autoimmune attack on vinculin.
- Anatomical reasons
- Classical reasons
- Surgical reasons
- Adhesions
- Postural orthostatic tachycardia syndrome (POTS)
- Ehlers-danlos
- Autoimmune Irritable Bowel Syndrome (IBS)
- Preventative therapy for SIBO
- Rifaximin use with prokinetic therapy
- Bifidobacterium Lactis HN019 as a therapeutic prokinetic.
- Testing for anti-vinculin antibodies on SIBO patients.
- POTS
- What’s the connection to SIBO?
- Why is the prevalence increasing?
- What is the connection between POTS and Mast Cell Activation Syndrome (MCAS)?
- Is there a potential for LPS and endotoxins to be travelling through nerves in the body?
- Restless Leg Syndrome (RLS), what it is, why do we get it, and what is the connection with SIBO?
- About hepcidin as an indicator of low serum iron in light of inflammation and how this is related to SIBO.
- For example: iron as a substrate for bacteria and how the body may respond by upregulating hepcidin to withhold iron from bacteria.
- Hepcidin as an antimicrobial peptide and its role in infectious diseases.
- The link between hepcidin and RLS.
- Why endorphins may be upregulated to protect the dopamine function in the brain in the setting of iron deficiency.
- Dr Weinstock’s treatment strategies for RLS
- What to do if patient is unresponsive to Rifaximin therapy in light of SIBO positive testing.
- Low dose naltrexone (LDN) - its use in RLS.
- Low iron that does not respond to oral supplementation and the possible links to hepcidin.
- Biofilm therapy
- Exploring the 3 types of IBS in SIBO
- IBS - D
- IBS - M
- IBS - C
- The potential for large intestinal bacterial overgrowth (LIBO) to skew a hydrogen rise in SIBO tests that show consistent high methane from baseline.
- Treatment discussion for IBS - C
- Dr Jacobi’s recommendation of BioGaia Protectis reuteri probiotic for methanogen treatment.
- 5 drops twice daily used in the study Dr Jacobi mentions.
- A couple of herbs Dr Jacobi uses for methane dominant SIBO treatment
- Garlic
- Myrrrh
- Dr Weinstock’s clinical insights into the ileocecal valve (ICV) being chronically open and allowing reflux of bacteria up into small intestine from the large intestine.
Resources
- Dr Weinstock’s Specialists in Gastroenterology Clinic
- BioGaia Protectis
- Bifidobacterium Lactis HN019 as a therapeutic prokinetic.
Pre and Probiotic Use in SIBO
In this episode, Dr Nirala Jacobi is in conversation with Dr Jason Hawrelak on the topic of all things gut.
Dr Hawrelak is a researcher, lecturer, naturopath, and nutritionist with over 16 years of clinical experience. He also practices at Gould’s Natural Medicine - a 135 year old natural medicine apothecary and clinic in Hobart, Tasmania, Australia.
Dr Hawrelak completed his PhD examining the capacity of probiotics, prebiotics, and herbal medicines to modify the gastrointestinal tract microbiota. He is currently the senior lecturer in Complementary and Alternative Medicines at the University of Tasmania’s School of Medicine where he coordinates the evidence based complementary medicines programs. Dr Hawrelak also teaches the gastrointestinal imbalances unit, within the Masters of Science and Human Nutrition, and Functional Medicine Program at the University of Western States, in Portland, Oregon.
Topics discussed in this episode include:
- Dr Hawrelak’s 2016 lecture on Pre and Probiotics at the SIBO Summit 2017 - still available to practitioners as part of the SIBO Fundamentals online course.
- The website Dr Hawrelak developed, Probiotic Advisor, to help practitioners differentiate which probiotic strains and products are appropriate to different conditions.
- Recent probiotic research (2017) in relation to SIBO treatment and methane reduction.
- The importance of strain specificity in relation to therapeutic effect.
- Reseeding the gut with exogenous probiotics as an outdated concept, and the history of this ideology.
- Faecal transplants and the capacity of strains to remain in the gut as compared to probiotics taken in capsule form that does not.
- What metabolic modulation actions do probiotics have in the body, and how to integrate this with background changes to enhance the therapeutic effect.
- D-lactate V.S. L-lactate producing probiotic strains, and what systemic effects do each trigger?
- D-lactic acidosis and when this may occur.
- SIBO related symptom presentation and strain specificity for probiotic therapy, for symptoms such as motility issues, abdominal hypersensitivity, histamine issues, food reactions.
Motility
- Probiomax for motility Bifidobacterium Lactis HNO19 - 1-2 capsules per day.
- BB12 Bifidobacterium Lactis for motility.
- Suggestions on the combination use in children with constipation.
- Animal study showing probiotic strains that work on the migrating motor complex function - prokinetic potential.
- Combination of L. Rhamnosus GG, Bifidobacterium BB12, and inulin.
Abdominal hypersensitivity in SIBO
- Bifidobacterium Infantis 35624
- Align
- Rhamnosus GG
- Functional abdominal pain in kids - meta analysis supporting this therapeutic application.
- Nissle 1917 strain of E.Coli
- Bifidobacterium Lactis DN173010
- Speed up transit time
- Decrease pain and bloating
- Yoghurt brand, Activia, available in US, is the only available form (as currently known)
Leaky Gut
- Probiotics useful in helping to repair leaky gut
- Rhamnosus LGG
- Biocodex preparation of Saccharomyces Cerevisiae/Boulardii
Histamine Intolerance
- Infiltration of mast cells into the intestinal wall in SIBO and histamine implication.
- Probiotics and histamine degradation - investigating
- Rhamnosus
- Infantis
- Plantarum
- Probiotics and histamine upregulation - investigating
- Casei
- Bulgaricus
- High-fat diets producing many bile salts, which feed hydrogen sulfide producing bacteria, and hydrogen sulfide gas contributing to leaky gut.
- Higher fat diets contributing to diamine oxidase (DAO) enzyme overuse in the small intestine and why this is relevant to histamine.
- Ketogenic diets and symptom resolution - why is this, and is it sustainable?
- The impact of starving out butyrate producing colonic flora.
- The risk of ketogenic diets.
Continued
- How to reintroduce foods to sensitive patients
- Heal gut
- Decrease inflammation
- Work on allergy axis to increase dietary diversity
- Partially hydrolysed guar gum (PHGG) as a prebiotic
- Probiotics as aiding in the recovery of the microbiome after an insult, eg chemotherapy, antibiotics, radiotherapy etc.
- Prebiotics and changes of diet having a greater impact on the gut microbiome.
- Jason’s prebiotic use
- PHGG - use in functional constipation patients, non-methane type SIBO, and diarrhoea type stool conditions.
- Helps to normalise stool.
- Bimuno - galacto oligosaccharides
- Bringing bifidobacterium, and faecalibacterium prausnitzii populations back.
- Faecalibacterium prausnitzii:
- The single species with the highest prevalence in healthy people.
- Predominant butyrate producer.
- Produces another anti-inflammatory gut healing compound, so helpful for inflammatory bowel diseases.
- Higher levels as protective against metabolic syndrome and Type 2 Diabetes.
- Akkermansia
- Accounts for 1-3% of the microbiome in healthy people.
- Eats mucin, therefore if inflamed guts producing a lot of mucus can overgrow akkermansia.
- Lactulose
- Use as a prebiotic.
- Increases faecalibacterium prausnitzii, akkermansia, and bifidobacteria, lactobacilli.
- Use as a pH changer - moves environment to be more beneficially acidic.
- Amazing capacity to decrease Bacteroides numbers - which can increase after multiple courses of antibiotics.
- SIBO positive on Lactulose breath test patients - to attend to SIBO with therapy first before using Lactulose as a prebiotic.
- Lactulose uses in recurrent urinary tract infections as supported by clinical trials - as it decreases levels of E.coli in the gut so fewer pathogens can make the journey from the anus, to the vagina, to the urethra.
- Prokinetic for small intestine and when it is appropriate to use it in SIBO.
- Note: lactulose will increase gas, but not bloating. If bloating, cease use.
- Discussion on soil based organisms as they relate to functional digestive disorders.
- Faecalibacterium prausnitzii:
- Bringing bifidobacterium, and faecalibacterium prausnitzii populations back.
- PHGG - use in functional constipation patients, non-methane type SIBO, and diarrhoea type stool conditions.
Resources
- BioGaia sunflower oil based probiotics
- Blackmores Digestive Bio Balance
- Rob Knight - microbiome specialist
- Products mentioned:
- Motility
- Probiomax Bifidobacterium Lactis HNO19 - 1-2 capsules per day.
- Lactobacillus reuteri MM53 BioGaia strain
- Testing mentioned
- Ubiome
- GI effects from Genova Diagnostics
- Dr Hawrelak’s Probiotic Advisor
- Motility
In this episode Dr Nirala Jacobi is in conversation with Dr Denise Furness, molecular geneticist, registered nutritionist, and registered exercise professional.
Today’s discussion centres around nutrigenomics, methylation, and digestive health.
Dr Furness completed her PhD at CSIRO Human Nutrition and a postdoctoral fellowship at the University of Adelaide’s Research Centre for Reproductive Health.
Her research focused on folate, nutrigenomics, methylation and DNA damage in relation to pregnancy outcomes. She has published her work in peer-reviewed medical journals and regularly presents at national and international conferences.
In 2012 Dr Furness shifted from an Academic Research position to a consulting role at Your Genes and Nutrition, helping patients understand the role of nutrigenomics and genetic testing in relation to various health outcomes.
Dr Furness is passionate about helping couples achieve optimal health and wellness to improve their chances for natural conception and healthy pregnancy outcomes. She also holds regular educational seminars and workshops discussing the links between our genes and our environment, and how these impact on our health throughout all stages of the life cycle.
Topics discussed in this episode include:
Overview of methylation.
What to look out for with patients with ongoing digestive symptoms, and how can we utilise some of the genomic testing that’s available?
Methylation as being responsible for switching genes off and on - the epigenetic component, as well as neurotransmitters, detoxification, and many other functions.
How do we truly test methylation?
Genetic terminology suggestions.
How is methylation important in digestive issues?
How SIBO relates to methylation variations.
Nutritional cofactors implicated in the wider picture of methylation.
Dr Furness’s most recent collaboration project with Bioceuticals.
Clinical services
Genetic Testing options
Guidance with further testing
Which genetic testing service will serve your needs the best?
FUT2 gene variants and the link to digestive disorder.
FUT2 secretors and non-secretors, and the direct influence on the gut bacteria altering levels of Bifidobacterium and B12.
Detoxification (CYP450) systems and their prevalence in the gut versus the liver.
CYP polymorphisms, upregulation, and the resulting impacts on the digestive system.
Glutathione S-transferase (GST) phase 2 deletions and the requirement for detoxification support in light of the body using different, slower pathways.
Catechol-O-methyltransferase (COMT) as the safe pathway to process catechol oestrogen metabolites.
Nutrients that support COMT and methylation, such as magnesium and b vitamins, respectively.
Monoamine oxidase (MAO) enzyme system that helps to clear neurotransmitters.
Why support COMT and methylation during times of stress and anxiety.
Why to never just start with folate supplementally - The Folate Trap.
Why the gut is the first port of call for systemic health.
Dr Furness’s dosing inclinations.
B12 deficiency in the presence of oxidative stress (due to gut issues), the recommendation towards hydroxy B12 supplementation over any other forms of B12, and why.
Various testing that Dr Furness recommends.
DUTCH testing
8-Hydroxyguanosine as a marker of DNA damage and oxidative stress
Endotoxicity and lipopolysaccharides (LPS) and how this can affect certain genes
Low homocysteine and what this can mean.
Gut issues and the relationship with oxidative stress.
Where to start with a client who has genetic complexities and oxidative stress issues.
Methylation education necessities for practitioners.
Dr Furness’s plan for upcoming workshops in Melbourne, and online offerings for clinical application.
The transsulfuration pathway and what can go wrong here.
The Cystathionine Beta Synthase (CBS) SNP as the first step in transsulfuration pathway, which pulls homocysteine into the pathway, and the CBS impact in detoxification.
Sensitivities with sulphur and the relationship to CBS.
How one SNP does not provide the whole picture - look at the diet, lifestyle, symptoms, and testing, using an integrative picture to address the issue.
How B6 works to speed up the transsulfuration pathway, pulling homocysteine down into it.
Resources
Dr Denise Furness
Consults available at Your Genes & Nutrition, Brighton, Melbourne
Consults available at Your Health, Brighton, Melbourne
Genetic Testing Services
Smart DNA
Fit Genes
DNA Life
23&Me
Microbiome PCR testing
Ubiome
Dr Furness’s 1000 kit free link
Dr Anderson
DUTCH testing
8-Hydroxyguanosine as an indicator of DNA damage and oxidative stress
Doctor’s Data
8-Hydroxyguanosine as an indicator of DNA damage and oxidative stress
Today, Dr Nirala Jacobi is in conversation with Dr Michael Ruscio about the gut-thyroid connection and how it relates to SIBO.
Dr Ruscio is a functional medicine practitioner, chiropractor, clinical researcher, and host of the Dr Ruscio Radio Podcast. Dr Ruscio and Dr Jacobi both recently presented and connected at the Integrative SIBO Conference 2017 in Chicago.
Topics discussed in this episode include:
- How Dr Ruscio became interested in SIBO.
- What is the gut-thyroid connection? Discussion of 4 main areas:
- The way the gut affects thyroid autoimmunity
- The way the gut affects thyroid hormone absorption.
- The way the gut can cause hypothyroid-like symptoms, even when thyroid hormone levels are normal.
- Those on thyroid medication and/or have hypothyroidism, are at increased risk of SIBO.
- Being hypothyroid, or being on Levothyroxine as presenting an increased risk for SIBO, and why this may be.
- The SIBO-H.Pylori relationship and the increased risk of SIBO after conventional H.Pylori treatment.
- The relationship between H.Pylori and thyroid autoimmunity.
- Does Dr Ruscio treat H.Pylori even if the patient is asymptomatic?
- Pylori as an indicator of overall gut health.
- Pylori pathogenesis v.s. commensalism with the host.
- Recalibrating the gut microbiota in light of H.Pylori, with natural treatments such as:
- Probiotics
- Herbal antimicrobials
- N-acetylcysteine
- Testing for hypothyroidism
- What is true hypothyroid?
- What is subclinical hypothyroidism?
- TSH high
- T4 normal according to the reference ranges.
- When to treat hypothyroidism, and when not to.
- The relationship of gut inflammation to thyroid autoimmunity.
- Switching focus from treating the lab values, to treating the person and the underlying causes of disease.
- What testing does Dr Ruscio use diagnose thyroid issues?
- Thyroid antibodies and the response to diet and lifestyle adjustment.
- TPO antibodies between 100-300 and Dr Ruscio’s interpretation of this and patient care suggestions.
- TPO antibodies over 500 and the correlation to thyroid autoimmunity.
- Intestinal permeability and the link to autoimmunity.
- What are the other links between Hashimoto’s and SIBO? Implicated elements include:
- Impaired bile production.
- Impaired phase 3 detoxification.
-
What are Dr Ruscio’s preferred treatments for Hashimoto’s Thyroiditis?
- Vitamin D.
- Combined selenium, CoQ10, and magnesium.
- Best therapeutic duration for selenium supplementation discussed.
-
How exogenous thyroid hormone facilitates thyroid repair.
- Dr Ruscio’s thyroid medications and whether to use a T3, T4 combination, or a liquid thyroid medication, and which medication to consider in light of chronic digestive conditions. Examples of thyroid medications include:
- Nature-throid
- Armour
- Westthroid
- Dr Ruscio’s favourite thyroid tests
- TPO Antibodies
- Thyroglobulin Antibodies
- TSH
- Free T4
- Total T4
- Free T3
- Dr Ruscio’s gut tests:
- SIBO breath testing
- Pylori - blood samples for 3 different fractions of the antibodies - G, A, and M.
- Pylori stool test for stool antigen.
- Pylori breath test.
- Complete stool test.
- Blood or serum antibody testing for amoebas and candida antibodies.
- Dr Ruscio’s clinical newsletter for practitioners, launched January 2017, outlining real case studies, clinical research studies, practitioner questions of the month, and a monthly practice tip from Dr Ruscio for each month.
Resources
- Dr Michael Ruscio
- Dr Ruscio Radio Podcast
- Dr Ruscio’s practitioner-only newsletter.
- Metagenics International Congress, 2017 featuring Dr Michael Ruscio as a speaker.
- Book recommendation:
- Martin Blazer - Missing Microbes
- Examples of thyroid medications:
- Nature-throid
- Armour
- Westthroid
- Dr Ruscio’s favourite thyroid tests
- TPO Antibodies
- Thyroglobulin Antibodies
- TSH
- Free T4
- Total T4
- Free T3
Today, Chris Gebhardt joins Dr Nirala Jacobi to speak about constipation in SIBO.
Chris works at Resonance Complementary Therapies in Melbourne, Australia, and has been working with SIBO for 3-4 years. Chris graduated as a Naturopath from the Southern School of Natural Therapies in 1995, has done post graduate studies in Japanese Acupuncture.
Chris works with his partner, Natalie Cruttenden, also a Naturopath and SIBO practitioner. Chris introduced Dr Jacobi to the use of the herbal medicine, pomegranate, in SIBO treatment, which is also touched on today.
Topics discussed in this episode include:
- Chris’s journey to becoming a SIBO treating practitioner.
- Methane dominant SIBO and the constipation relationship.
- Chronic constipation beyond SIBO treatment - what is Chris seeing in his clinic with constipated patients who remain constipated even though methane levels are dropping?
- Post SIBO treatment therapies to support healthy digestion throughout the entire digestive tract.
- Resetting and stimulating peristalsis in the large intestine.
- The importance of supporting bowel movements during the antimicrobial SIBO treatment phase .
- The theory that high methane on baseline that remains elevated throughout the test reflects IBS-C and not necessarily SIBO (via SIBO breath testing).
- Chris’s clinical pearls for treating constipation, and supplemental supports:
- Prescript Assist
- Partially Hydrolysed Guar Gum (PHGG)
- Herbal based laxatives
- Metagenics laxatone
- Mediherb cascara complex
- Xymogen Probiomax Plus Sachets
- Bioceuticals Ultra Biotic 500 in later phases of SIBO treatment.
- Dr Jacobi’s supplement supports for peristaltic action
- Bifidobacterium Lactis HN019
- Found in Probiomax, and Orthoplex Multigen Biotic.
- Mutaflor - beneficial E.coli
- Bifidobacterium Lactis HN019
- Repair work to consider after Neomycin use.
- Dr Jacobi’s bowel retraining techniques:
- PHGG use
- Flaxseeds, chia seeds, and dietary adjustment to support bowel movements for patients with high methane production in the large intestine.
- Anatomical squatting position for best evacuation alignment.
- SIBOtest’s Resource - Retraining a Sluggish Colon
- Coffee enemas - Chris and Dr Jacobi’s opinions for therapeutic use.
- Kinesiological testing for the function of sphincters of the abdomen.
- Sphincter work and what type of constipation patients may respond better
- Chris’s seed blend for moving the bowels - chia seeds, linseeds, pumpkin seeds, sunflower seeds, almond.
- Methanogen specific herbal support
- Allisure
- Bactrex
- Atrantil
- Removing Methanobrevibacter smithii by moving the bowels.
- Testing available for high baseline methane and high methane throughout, and when to use this test - Methane Spot Test.
- Pomegranate - when to use it, what form to use, how often to use it, and Chris’s results from using it.
- Other herbs for treating SIBO and Small Intestinal Fungal Overgrowth (SIFO), including Usnea and Horopito.
- The Biphasic Diet and reintroducing FODMAP foods.
- The damage to the villi in light of SIBO and repercussions of this.
- SIBO relapse, and how to integrate a repair phase to lessen the occurrence of this, either post treatment, or pretreatment (as indicated in the The Biphasic Diet)
- Chris’s treatments for gut repair:
- Prebiotic rotation.
- Lactulose
- Bimuno galacto-oligosaccharide (GOS)
- Fibre integration.
- Soluble
- Insoluble
- Probiotics
- Colonic foods (polyphenols)
- Green tea
- How SIBO causes leaky gut and damage to the brush border enzymes.
- Chronic SIBO patients who relapse and why they may relapse.
- Dr Jason Hawrelak’s talk at the SIBO Summit 2016 on pre- and probiotics.
- Dr Jacobi’s gut repair program
- Vitamin A
- Zinc - 60mg
- Bimuno GOS
- Stress as a factor in sluggish bowels.
- Supporting serotonin for gut motility.
- Prebiotic rotation.
Resources
- Resonance Complementary Therapies
- Melbourne, Ashburton, Australia.
- (03) 9885 5964
- SIBOtest practitioner education and patient handouts
- Chris’s supplemental supports:
- Prescript Assist
- Partially Hydrolysed Guar Gum
- Herbal based laxatives
- Metagenics laxatone
- Mediherb cascara complex
- Xymogen Probiomax Plus Sachets
- Bioceuticals Ultra Biotic 500 in later phases of SIBO treatment.
- Dr Jacobi’s supplement supports for peristaltic action:
- Bifidobacterium Lactis HN019
- Found in Probiomax, and Orthoplex Multigen Biotic
- Mutaflor - beneficial E.coli
- Bifidobacterium Lactis HN019
- Squatty Potty
- Easy Stool
- Chris’s seed blend for moving the bowels - chia seeds, linseeds, pumpkin seeds, sunflower seeds, almond.
- Methanogen specific herbal support
- Allisure
- Bactrex
- Atrantil
- Methane Spot Testing
- The Biphasic Diet
- Bimuno
- Dr Jason Hawrelak’s talk at the SIBO Summit 2016 on pre and probiotics.
- SIBOtest’s Resource - Retraining a Sluggish Colon
In this episode Dr Nirala Jacobi continues the conversation with Dr Bradley Bush, with a focus on case presentations around chronic SIBO cases and inflammatory concepts.
Dr Bush received his Naturopathic Doctorate degree from the National College of Naturopathic Medicine. He is co-owner and clinic director of Natural Medicine of Stillwater and its online consumer direct website for practitioners, neurovanna.com.
The Bush practice focuses on fatigue, insomnia, GI disorders, mood disorders, and lyme disease. Dr Bush has over 16 years of industry experience. He is the owner of Natural Health Insights, providing consulting services to the naturopathic products and laboratory testing industry.
Dr Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology, and lyme disease. Dr Bush sits on two non profit boards, The Naturopathic Education and Research Consortium, and Compass Centre for Health.
The format of this episode is slightly different. In it Dr Bush discusses three different SIBO cases, diving into the variability and complexity of each presentation.
Case 1 - SIBO with associated fibromyalgia and chronic fatigue - 65y/o female.
- Incremental approaches with complex cases.
- The gut being the epicentre of health, without which SIBO associated presentations will not rectify.
- Polypharmacy approach and the compounding effect of this on the patient.
- Analysis of basic chemistry.
- Myeloperoxidase (MPO), the enzyme secreted by neutrophils, and the indications for testing and tracking this in treatments. (MPO elevation has associations with lipopolysaccharides (LPS), chronic infections, irritable bowel disease (IBD), and immune induced leaky gut)
- The neurotransmitter imbalances that can be sustained by chronic inflammation (hint - upregulated indoleamine dioxygenase enzyme, precipitating downregulated synthesis of serotonin, among others)
- Yeast association with SIBO.
- Weaning off polypharmacy.
- Metronidazol for rifaximin resistant SIBO, and C. diff.
- An indication on how many rounds of rifaximin are required to attend to chronic versus acute SIBO.
- Eating disorders prompted by therapeutic diets taken on for too long.
- Botanicals vs conventional medicine for SIBO treatment, or a combination use approach?
- Probiotic use as immunological modulators rather than massive impactors for floral diversity in the GI microbiome.
- Botanicals that Dr Bush uses in SIBO treatment.
- Mediherb gut flora complex - immune regulating capability, IBD modulation, mucosal affinity.
- Dr Nirala Jacobi’s therapeutic recommendation - Mediherb Bacto-Cand GI.
Case 2 - SIBO with associated constipation, acne, halitosis - 20y/o male
- Traumatic brain injury due to sporting event.
- Tricyclic antidepressant therapy introduced in his recovery plan and his subsequent experience of anxiety and spacey feelings.
- Naturopathic neurotransmitter production therapy alongside conventional antidepressant use.
- Serotonin syndrome and the potential for it to be induced by dual therapy use.
- Methane Protocol - rifaximin and neomycin combination for methane dominant SIBO treatment.
- Anxiety caused by SIBO, key indications being:
- Treatment resistant anxiety
- Treatment resistant insomnia
- Anxiety as a manifestation resultant of SIBO chemicals interrupting neurotransmitter signalling.
Case 3 - Lyme and SIBO - 25y/o female
- Chronic fatigue, constipation, bloating, neuralgia, catatonic staring episodes.
- Lyme testing.
- The effectiveness of the paleo diet for symptomatic control, noting that the issue still exists, even though the bugs are simply not being fed and therefore symptoms abating.
- SIBO as a concomitant condition with Lyme, and/or as a condition that can mimic the various presentations of Lyme.
- The Lyme/SIBO overlap as discussed by Dr Farshid Rahbar at the 2017 SIBO Integrative Conference, and the methane association.
- The clinically noted neuralgia and methane dominance link.
- Methane endotoxins produced by SIBO bacteria theorised to contribute to neuralgia.
- Constipation and methane dominance perpetuating each other.
- Methane dominant SIBO moving from constipation to diarrhoea during treatment and why this can occur.
Resources
- Dr Bradley Bush
- Clinic website - Still Water Natural Clinic
- Direct consume website for practitioners - Neurovanna
- Therapeutic recommendation, Mediherb gut flora complex
- Dr Nirala Jacobi’s therapeutic recommendation
- Mediherb Bacto-Cand
- Naturopathic Education and Research Consortium
- Compass Centre for Health
- Dr Farshid Rahbar
- SIBOtest episode - SIBO and Lyme Disease
- SIBO Integrative Conference
In this episode Dr Nirala Jacobi speaks with Dr Bradley Bush about the fascinating and complex world of neurotransmitters.
Dr Bush received his Naturopathic Doctorate degree from the National College of Naturopathic Medicine. He is co-owner and clinic director of Natural Medicine of Stillwater and its online consumer direct website for practitioners, neurovanna.com.
The Bush practice focuses on fatigue, insomnia, GI disorders, mood disorders, and lyme disease. Dr Bush has over 16 years of industry experience. He is the owner of Natural Health Insights, providing consulting services to the naturopathic products and laboratory testing industry.
Dr Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology, and lyme disease. Dr Bush sits on two non profit boards, The Naturopathic Education and Research Consortium, and Compass Centre for Health.
In this episode topics discussed include:
- Who are the major players in the enteric nervous system for neurotransmitter regulation?
- Does low serotonin in the gut mean low serotonin in the brain?
- The sympathetic-parasympathetic rhythm, and how important this is in calibrating the smooth muscle movement in the gastrointestinal tract.
- Underlying factors to sympathetic dominance in a person, such as chronic infection, dysbiosis, and/or inflammation.
- The complex presentations of sympathetic overdrive, ranging from anxiety and insomnia, to exhaustion, and why this is.
- Why increased norepinephrine in conjunction with normal or low epinephrine is a worse situation than just high epinephrine, due to the lack of counter balance for inflammation and an upregulated innate immunity.
- Repercussions of high epinephrine in conjunction with low norepinephrine.
- The multiple actions of cortisol, epinephrine, and norepinephrine in the body and their roles in acute and chronic conditions.
- Urinary transmitter analysis, stability, and recommended labs.
- Nutrients used to support synthesis of the various neurotransmitters.
- L-dopa v.s. tyrosine use, and the various benefits of each.
- Clinical indications for L-dopa use.
- How depleted catecholamines can be related to low secretory IgA.
- Genetic mutations (MTHFR) and how this relates to neurotransmitter dysfunction.
- Does serum C-reactive protein (CRP) directly correlate to SIBO activity?
- Myeloperoxidase measurement as a marker of neutrophil activity, and how it can be a useful monitoring tool for irritable bowel syndrome (IBS) and irritable bowel disease (IBD) patients.
- How does inflammation turn down the synthesis of serotonin and catecholamines?
- How the indoleamine 2,3-dioxygenase enzyme (IDO) conducts “The Tryptophan Steal” as an outcome of chronic inflammation, and the implications of this.
- What solutions are there to address the tryptophan steal?
- The benefit of using supplemental 5-HTP over tryptophan in light of chronic inflammation and impacted adrenal health.
- Doses, dose timing, and length of time to use 5-HTP.
- SIBO as a common underlying factor for the inflammatory state that can drive neurotransmitter dysfunction.
- What is the role of glutamate?
- Glutamate versus glutamine, and how is this relevant to supplementation.
- How is glutamate measured, what do high levels indicate, and how does it impact the nervous system?
- Glutathione as the biggest byproduct of L-glutamine metabolism.
- Powder V.S. tablet for L-glutamine use, and the dose recommended.
- What is urinary neurotransmitter testing reflecting?
- The blood-brain barrier, and how the brain is not a closed system.
- MTHFR and COMT genetic testing as indicated by low monoamine neurotransmitters and high catecholamines on urinary neurotransmitter panels.
- What to do with patients on medications being used to conventionally regulate neurotransmitters?
- Tactics of improving neurotransmitter markers prior to SIBO treatment in order to offset the flaring of the symptoms during die off.
Resources
- Dr Bush’s lab recommendations
- Pharmasan Labs
- Labrix
- Dr Bradley Bush
- Clinic website - Still Water Natural Clinic
- Direct consume website for practitioners - Neurovanna
- SIBOtest for SIBO testing options.
Dr Farshid Rahbar, holistic and integrative gastroenterologist in Los Angeles, joins Dr Nirala Jacobi today to speak about Lyme disease and Tick Borne Disease (TBD) in relation to SIBO and other digestive disorders.
Dr Rahbar is the medical director at the LA Integrative Gastroenterology. In 2007, he completed the integrated medicine training, achieving ABIHM status. Dr Rahbar also undertook training in anti-aging, functional, and regenerative medicine, achieving board certification through A4M. He then completed further training through IFM - The Institute for Functional Medicine, and ILADs training.
In 2013 he delved into the relationship between tick borne Lyme disease with a special interest in gastrointestinal (GI) manifestations. Since this time he has witnessed clinical patterns involving the role of infections, acute and chronic, in causing ongoing GI related conditions and symptoms.
Dr Rahbar’s special interest areas include dysbiosis, SIBO, leaky gut, and measures that help these conditions. Like many other experts, he believes that GI integrity is crucial to the treatment of Lyme. Further, both Dr Rahbar and Dr Jacobi recently presented at the 2017 Integrative SIBO Conference held in Lombard, Illinois.
In this episode
- How Dr Rahbar got into the field of integrative gastroenterology with a specialty in Lyme.
- An overview of what Lyme disease is.
- Tick Borne Disease (TBD) and how borreliosis is one amongst many possible infections.
- Testing for Lyme and TBD and the political discord surrounding this.
- Unexplainable chronic inflammatory conditions and how they may require testing for TBD.
- What are the core clinical presentations of Lyme and co-infections that Dr Rahbar sees in his practice?
- Key presenting components that may indicate TBD - such as fatigue, and neurological dysfunction.
- Anxiety, medical marijuana use, and body aches in young people, and how these may indicate chronic inflammation and warrant TBD investigation.
- Autoimmunity and how Bartonella infection can be implicated.
- What is the connection between Lyme and SIBO?
- SIBO as a phenotypic presentation of underlying TBD infection.
- Testing options for Lyme and coinfections and how accurate these are, and options for referral to experts.
- Mould, mycotoxicity, and chronic inflammatory response syndrome (CIRS) and how presentations for this can be similar to TBD infections, and chronic immune compromisation.
- How lifestyle factors and certain genetic profiles can increase risk factors and susceptibility to TBD, CIRS, and immune conditions.
- Speculation on nose cultures indicating the possibility of post nasal drip at night, with concomitant hypochlorhydria and/or immune dysregulation, being a risk factor for dysbiosis and SIBO.
- Lyme, mycotoxicity, stealth infections, and the theory that the chronic immune issues and how the microbiome decimation of the last 50 years can be impacting the ability to regain health.
- High methane levels in Lyme patients and how this can be related to immune suppression.
- Dysautonomia and small fibre neuropathy in the stomach itself, and the relationship to Lyme.
- GERD as a risk factor for SIBO.
- The lower esophageal sphincter (LES) and why dysfunction may occur when the autonomic nervous system is affected.
- The constellation of autonomic neuropathy, dysbiosis, pyloric valve insufficiency, and bile reflux and how any and all of these may lead to GERD.
- How is dysautonomia diagnosed, and is it only related to Lyme, TBD, and coinfections?
- Gastroparesis and how it may be related to dysautonomia, Lyme, and other TBD.
- Inflammatory cytokine release and how this cascade may relax the LES and contribute to SIBO.
- The tightness of the fundus and how it could contribute to reflux oesophagitis.
- Methane dominant SIBO and retrograde motility leading to symptoms such as burping, and nausea.
- Dr Rahbar’s clinical pearls for SIBO patients.
- Dr Rahbar’s phases for SIBO treatment:
- Preparatory phase
- Attack phase
- The place of nystatin in lower bowel dysbiosis and fungal overgrowth.
- Biofilm disruptors for TBDs.
Resources
- Dr Farshid Rahbar
- LA Integrative Gastroenterology & Nutrition
- Dr Shoemaker
- Mould literacy website for patients and physicians - Surviving Mold.
- Dr Scarpenyarto
- Proceedings of the 2nd International Symposium - Diverticular Disease of the Colon - Rome, April 2016
- Frank Netter
- Medical artist
- Nutraceuticals
- Orthomolecular
- Xymogen
- EnteraGam
- Symbiotics
In this episode, Dr Nirala Jacobi (ND, USA) discusses SIBO breath testing.
Dr Jacobi’s experience ranges from professional practitioner education, product development, naturopathic mentorship, and serving on the board of directors for the American Association of Naturopathic Physicians (AANP), to running her own private clinical practice for over 20 years.
Dr Jacobi is the founder and medical director of SIBOTest, and is a highly sought after specialist for the treatment of functional digestive disorders.
Stay tuned at the end of this episode for a conference update with Dr Audra Mehan, conference director CME for the Integrative SIBO Conference in Lombard Illinois. Dr Jacobi is one of the many high calibre featured speakers for this event, set to be held on March 25th and 26th 2017.
Topics discussed in this episode include:
- What is SIBO Breath testing?
- What gasses we are testing for?
- How does a person perform a SIBO breath test at home?
- Preparation protocol, the diet involved, and supplements, herbs, and medication to avoid in the preparation period.
- How to know which test to give to a patient - Lactulose, Glucose, or Fructose.
- Hydrogen sulfide - are there testing options for this gas, what patterns on a SIBO breath test may indicate an overgrowth of bacteria that produce hydrogen sulfide, and what symptoms could indicate hydrogen sulfide dominance?
- What organisms produce hydrogen sulfide, and what do they feed on?
- How can children perform the SIBO breath test?
- What to ask your SIBO testing facility to ensure the highest testing quality.
- What constitutes a positive SIBO test result, and what constitutes a borderline SIBO test result?
- How to read and interpret a SIBO breath test result.
- Diarrhoea and constipation during SIBO breath testing and how this can affect test interpretation.
- High methane on baseline compared to methane that rises, and what this means.
- The relationship of hydrogen to methane, and how hydrogen producing bacteria can cause a rise in methane gas production.
- Reference ranges for SIBO gases.
- How to know when to retest, and whether to retest.
- The SIBO treatment algorithm.
- The methane spot test, and when it is indicated.
- Questions from listeners
- Visceral manipulation therapy - what it is, and how it may complement SIBO treatment.
- Is there a role for fecal microbial transplant into the small intestine for the resolution of SIBO?
- What are the treatment options for pregnant women with SIBO?
- Dr Audra Mehan, conference director CME, discusses the phenomenal speaker line-up for the Integrative SIBO Conference 2017, set to be held in Lombard Illinois on March 25th and 26th 2017.
- Attend this event.
Resources
- SIBOtest breath testing video - how to collect breath samples correctly.
- Test comparison chart - some ideas for what to ask your facility to ensure testing is of highest quality.
- Order a SIBO breath test
- SIBO test Practitioner Resource Portal
- Alyssa Tait - visceral manipulation therapist, Brisbane.
- The Barral Institute
- Cedar Sinai - Dr Mark Pimental
Follow Up:
- Contact Carly with any practitioner questions you’d like to see answered on the show
- Attend the Integrative SIBO Conference - either in person or via webinar.
In this episode, Dr Nirala Jacobi speaks with Heidi Turner on the topic of Mast Cell Activation Syndrome. Heidi is a medical nutrition therapist at the Seattle Arthritis Clinic at Northwest Hospital UW Medicine in Seattle, Washington. She specialises in food intolerances, SIBO, and other digestive disorders, addressing the digestion in order to balance all body systems.
In this episode topics include:
- Using diet to decrease inflammation in the body and improve pain markers for autoimmune patients.
- Mast cell activation syndrome (MCAS) and the diverse array of signs and symptoms with which it can present.
- SIBO and how it relates to mast cells disorder and MCAS.
- What mast cells are and what responses they create within the immune system.
- Predisposing factors for MCAS
- The physiological relationship of stressors, and/or emotional trauma to the development of MCAS and other conditions in the body.
- Histamine Its diverse roles in the body.
- Intolerance symptoms.
- How intolerance can develop.
- High histamine foods.
- How to best assess patients for histamine intolerance.
- Antihistamine supplements.
- Diamine Oxidase (DAO) and SIBO related histamine dysregulation.
-
How to navigate probiotic treatment for highly digestively sensitive patients.
-
Various treatment options for stabilising mast cells, and MCAS specific support.
Resources
- Dr T C Theoharides www.mastcellmaster.com
- Mast cell cytosis society www.tmsforacure.org" alt="" />
- Pubmed
- Heidi Turner www.foodlogic.org www.eliminationdietrd.com
In this episode, we delve into the relationship between Candida Albicans and SIBO. Our host, Dr Nirala Jacobi, is in conversation with Dr Margaret Beeson.
Dr Beeson has over 40 years in medical practice, having started as a nurse in the US Navy and then moving to become a Naturopathic physician. She founded the Yellowstone Naturopathic Clinic in Billings, Montana, and is the President and Co-founder of the Naturopathic Education and Research Consortium to increase post graduate training in the USA.
Dr Beeson is also the president of the Paul Gardener Veterans Pain Relief Foundation, and is the recipient of 2016 Physician of the Year award from American Association of Naturopathic Physicians. She is a national leader in efforts to advance the quality of naturopathic care.
Topics discussed in this episode include:
-
Small intestinal fungal overgrowth (SIFO) and large intestinal fungal overgrowth in relation to candidiasis.
-
The comorbidity relationship of SIFO to SIBO.
-
Endotoxin association with SIFO.
-
The metamorphic abilities of candida and its ability to hide in the body, including candida antibodies versus counter antibodies.
-
Candida as a symptom of dysbiosis.
-
Biofilm and candida living as a part of diverse bacterial colonies rather than solitary candida colonies.
-
Yeasts and their pathogenic potential.
-
Microbiome terrain disturbance as a key player in candida infection progression.
-
Die off as stronger with fungus than with bacteria.
-
Candidal hyphae, the mucosal wall, and the potential for leaky gut.
-
Hallmark symptoms of candida.
-
The 4 forms of candida, and which is the most invasive and detrimental.
-
Testing and symptomatic identification of candidiasis.
-
Organic acid testing and candidiasis diagnosis.
-
Fibromyalgia, tartaric acid, and the candidiasis connection.
-
Saccharomyces boulardii tolerance and/or use during yeast infection.
-
Reactions to kombucha and why they might occur.
-
Folliculitis as a symptom of yeast and staph cohabitation infection.
-
Nystatin (nilstat), how it works, safety profile, affordability, treatment options, length of treatment, and recommended daily unit intake.
-
The role of biofilm disruptors in treatment.
-
Candida as a contributor to salicylate sensitivity.
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Dr Jacobi’s SIBO specific treatment herbs and how they can also address candida.
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Saccharomyces boulardii and its adherence action to encourage friendly flora.
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Specific prebiotics, whole food diets, and their role in repopulating microflora diversity in the gut.
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Dr Beeson’s complementary protocols and therapies to consider during candida treatment.
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Is candida albicans a trigger in the onset of coeliac disease?
Resources
- Dr Margaret Beeson
○ Yellowstone Naturopathic Clinic, Billings, Montana
- Probiotics Dr Beeson uses
○ Human Lactic Commensals from Farmax.
- Dr Anderson and biofilm
- Dr Jason Hawrelak, probiotic expert, speaks at the SIBO summit
Dr Nirala Jacobi speaks with Dr Donna Beck, Naturopathic Doctor, with over 20 years of clinical experience at her integrative medicine private practice in Portland, Oregon. Dr Beck specialises in the customisation of bioidentical hormone therapy, and digestive disorders. Today Dr Beck talks to us all about salicylate sensitivity - a condition that can be implicated with SIBO.
Topics discussed in this episode include:
- What are salicylates, and what foods are they in?
- What causes the tip of balance in our bodies into salicylate sensitivity?
- The role of stress in the onset of salicylate sensitivity.
- Metabolic acidosis, respiratory alkalosis, immune dysregulation.
- Salicylate sensitivity and how it can be implicated with SIBO.
- What naturopathic medicines contain salicylates?
- The diverse symptoms that can present with salicylate sensitivity.
- Treatment options for salicylate sensitivity.
- The crucial role of minerals in salicylate treatment.
- Symptomatic relief from acute sensitivities.
- Enzyme deficiencies and unique treatment options using single enzyme therapy.
- Digestive flora and the role of species destruction in sensitivity development.
- The relationship of yeast overgrowth to sensitivity development.
- Salicylate sensitivities as a treatable metabolic phenomenon rather than a chronic condition.
- Monitoring strategies to test sensitivity treatment progress.
- Diet resources for salicylate sensitive patients.
- Common foods high and low in salicylates.
- Therapeutic herbs that are high, and low in salicylates.
- Topical considerations for salicylate sensitivities
- How salicylates are metabolised and how to support these pathways with diet.
- Salt as a major driver of acidity.
- Food reintroduction strategies for patients are or have been quite restricted.
- Buteyko breathing before meals.
- Testing options and recommendations.
- Are parasitic infections implicated in salicylate sensitivity?
- Water quality and pH requirements for best digestive health.
- Planetary stress and how this is impacting salicylate production in plants.
Resources for listeners
- Dr Donna Beck
- Location - Gresham, Oregon
- afamilywellnesscenter.com
- Email: afwc330@gmail.com
- Dr Anne Ruth Swain - Salicylate specialist from Australia
- A salicylate content of herbs guide - Dr Donna Beck is collaborating with Glen Nagle and it is in production.
- Dr Feingold & the Feingold diet for hyperactive children
- Feingold association
- Dr Paul Saint Amand
- Fibromyalgia treatment centre
- Buteyko breathing
Here we are following on from Episode 2 - SIBO Queen Insights Part 1. Dr Nirala Jacobi continues the conversation with Dr Allison Siebecker about their clinical experiences, research, and SIBO insights.
Topics include:
- How to approach treatment with patients who are severely food restricted and have SIBO.
- Challenges experienced as a practitioner working with chronically ill patients.
- The importance of taking a methodical approach to SIBO treatment.
- Other functional tests recommended alongside SIBO testing and treatment, such as:
- Stool testing
- Blood testing
- Hormonal testing (sex hormones, adrenals, thyroid)
- Yeast overgrowth in SIBO and how to approach this in treatment.
- How hormonal imbalances in the body can affect motility of the small intestine and the testing necessary to get the full SIBO picture.
- UBiome PCR testing on the microbiome to ascertain species diversity in the GIT.
- Comparing modern civilisation microbiota diversity to that of tribal groups and how to use diet to start to diversify species in an environment inclining towards decimation.
- The way to use testing in methodical SIBO treatment.
- What SIBO tests to use, lactulose, glucose, or fructose, or all of them?
- What is on the horizon for hydrogen sulfide dominant SIBO testing?
- Practitioner pearls and protocols.
- Partially hydrolysed guar gum and practitioner feedback using this in SIBO treatment.
- Dietary tips for symptom relief, and treatment of SIBO.
- Prebiotics recommended by Dr Jason Hawrelak.
Resources
www.siboinfo.com - Dr Allison Siebecker’s website
SIBO Summit 2016 - Recordings available of expert speakers
Thanks for listening, and catch you next time!
The SIBO Doctor podcast crew
ABOUT DR ALLISON SIEBECKER
Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic and has specialized in the treatment of SIBO since 2010. Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, Board of Advisor for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums, teaches continuing education classes for physicians, and is the author of the free educational website siboinfo.com. In 2005, 2013 and 2015 she received the Best in Naturopathy award from the Townsend Letter, for her articles: “Traditional Bone Broth in Modern Health and Disease”, "Small Intestine Bacterial Overgrowth: Often Overlooked Cause of IBS" and “SIBO: Dysbiosis Has A New Name”. Dr. Siebecker is currently writing a book synthesizing the SIBO data into one source.
In this episode Dr Nirala Jacobi invites Dr Allison Siebecker on the show. Dr Siebecker is a highly respected Naturopathic Physician and internationally recognized SIBO expert. Listen in to this episode for a plethora of clinical pearls.
This is a comprehensive discussion about SIBO, and as such listeners are invited to watch the Free 90 minute Advances in the Treatment and Management of SIBO Webinar before diving into this episode.
Topics discussed include:
- What brought Dr Siebecker to Naturopathic Medicine and SIBO specialisation.
- How the MD and ND worlds are amalgamating, sharing information, and maximising collaborative SIBO research, treatment, and ultimately patient outcomes.
- Methane dominant SIBO treatment.
- Diets appropriate to SIBO management.
- The IBS check - a blood test that is available in the United States, that tests for SIBO caused by post-infectious gastroenteritis.
- Prokinetics and when to use them.
- Historical conventional antibiotic use in SIBO treatment as compared to now.
- SIBO retesting and re-treatment recommendations.
- Stress and its effect on the enteric nervous system and secretory IgA.
- Diet, lifestyle, herb, and nutrient based treatment options for SIBO.
- Atrantil - how Dr Siebecker has found using this herbal blend clinically for methane dominant SIBO gas reduction and healing leaky gut.
Texts talked about include:
- Functional Gastroenterology - Dr Steven Sandberg Lewis
- Breaking the Vicious Circle - Elaine Gottschall
Resources
www.siboinfo.com - Dr Allison Siebecker’s website
SIBO Summit 2016 - Recordings available of expert speakers
Thanks for listening, and catch you next time!
The SIBO Doctor podcast crew
ABOUT DR ALLISON SIEBECKER
Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic and has specialized in the treatment of SIBO since 2010. Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, Board of Advisor for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums, teaches continuing education classes for physicians, and is the author of the free educational website siboinfo.com. In 2005, 2013 and 2015 she received the Best in Naturopathy award from the Townsend Letter, for her articles: “Traditional Bone Broth in Modern Health and Disease”, "Small Intestine Bacterial Overgrowth: Often Overlooked Cause of IBS" and “SIBO: Dysbiosis Has A New Name”. Dr. Siebecker is currently writing a book synthesizing the SIBO data into one source.
In this episode, Dr Nirala Jacobi is in conversation with Carly Woods, recent Naturopathic graduate. Here, Dr Jacobi addresses common SIBO questions and invites listeners to join the discussion. Topics covered include:
- Dr Jacobi's motivation behind starting the podcast, The SIBO Doctor.
- The gut and its role in the health of the body as a whole.
- SIBO and how it can cause leaky gut.
- Explaining zonulin and its role in maintaining gastrointestinal integrity.
- The autoimmune aspect of SIBO.
- Cytolethal distending toxin B and how it is implicated in vinculin destruction, compromising the migrating motor complex.
- Adhesions and the role of visceral manipulation in SIBO treatment.
- Dr Jacobi’s Bi-Phasic Diet and how to integrate methodical SIBO treatment.
- Herbs and nutrients that Dr Jacobi’s recommends for gut healing and SIBO treatment.
- A look into the different types of bacteria that are involved in SIBO development.
- Conventional SIBO treatment and Rifaximin use.
- Nutrients, herbs, and conventional medicines used to encourage the Migrating Motor Complex, and when to use them.
- The effects of modern civilisation on gut microbiome health and systemic well-being and ways to diversify flora.
We love connecting with practitioners and collaboratively navigating the complexities of SIBO.
If you’d like your question to be featured on the show, we invite you to email your question to Carly.
Thanks for listening, and catch you next time!
The SIBO Doctor podcast crew
ABOUT DR NIRALA JACOBI Dr. Nirala Jacobi is recognised as Australia’s leading SIBO specialist. She is the founder of SIBO Test, an online SIBO testing facility. Her website is full of useful information and resources. Take a free quiz to find out if you have SIBO, or find a practitioner near you. Dr. Jacobi offers Skype consultations, which can be organised via her website.