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The Case: 

• Alexandra’s everyday was determined by the state of her stomach
• She was often bloated, gassy, and struggled to keep her weight healthy
• She tried restrictive diets, tried over the counter gas remedies, digestive enzymes, and various probiotics but nothing gave her long-term relief

The Investigation

It was clear that there was something going on with her gut and it seemed likely that dysbiosis was at play. I knew her microbiome needed support but, I also suspected that with everything she’d tried, we needed to approach the solution methodically as there was likely more than one thing going on. 

Gut issues and the state of our microbiome plays a huge role in how we feel physically but it can also seriously impact our mental health, organ health, immune system, and our ability to lose or maintain a healthy weight. 

Wheat Belly Author’s Latest Book

When it comes to understanding gut health and addressing Alexandra’s problem, I knew that one of the best people to talk to would be the author of the best selling book, Wheat Belly. Dr. William Davis has a new book out called Super Gut where he addresses exactly what Alexandra is going through. The book also shares a ‘4-week place to reprogram your microbiome, restore health, and lose weight’. 

Symptoms of a Disrupted Gut Microbiome

There are many symptoms that could point to a disruption in the microbiome balance. Most people think of the symptoms that Alexandra was experiencing because they are related to the gut itself (bloating, gas, cramping, diarrhea, constipation, etc) but there are many other issues that can be traced back to microbiome disruption. Dr. Davis points to a myriad of issues including, weight gain, skin rashes and eczema, arthritis, pain, inflammation, wrinkles and healthy skin, and sleep health. He also believes that just about every human disease needs to be reconsidered in light of the microbiome.

What Causes the Microbiome to be out of Balance?

There are many reasons that the microbiome may be out of balance including use of antibiotics as well as other drugs like stomach acid blocking drugs, nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen diclofenac), synthetic sweeteners (Aspartame, sucralose and saccharin),  emulsifying agents (Sorbate 80, carboxymethyl, and cellulose), and even something as common as stress can disrupt microbiome. 

One condition that is directly related to microbiome health is the silent epidemic of SIBO. 

What is SIBO

SIBO stands for Small Intestine Bacterial Overgrowth. Dr. Davis says that many people have SIBO but go undiagnosed (which can lead to long-term health issues). There is now a breath test that people can do to better understand SIBO and where the bacteria overgrowth is happening, specifically, in the digestive pathway. 

Microbes belong in the colon which has a protective barrier against microbes. When there is an imbalance or overgrowth, microbes can end in the small bowel where the mucus barrier is thinner and can be easily damaged by these misplaced microbes. 

Exposure to antibiotics and emulsifying agents can further erode the lining as well as disrupt the balance of stool microbes like E coli, and citrobacter. These proliferate and offset the balance. And then, these microbes die (within a few hours) and release a lot of byproducts that break down and make it into the bloodstream. This process results in something called endotoxemia which is extremely toxic to humans. With all of this going on internally, it can be difficult to detect but may show up as depression, brain issues, joint swelling or intestinal issues. 

Dr. Davis estimates that 1 in 3 people are dealing with SIBO which can lead to Endotoxemia when untreated. 

Testing for SIBO

Conventional doctors can conduct a test for SIBO but Dr. Davis says the method they use does not identify all forms of SIBO. 

One of the early signs of SIBO is the presence of hydrogen gas (produced by the bacteria) within 90 minutes of consuming food. The quicker it shows up, the further up the GI tract the imbalance is occurring. 

Signs we often attribute to food intolerances may in fact be related to SIBO. For example, if you eat black beans and experience bloating, gas, and/or diarrhea in about 30 minutes then it is virtually 100% reliable that you have SIBO. 

Another sign of SIBO is fat malabsorption. If you look in the toilet, you see fat droplets or staining of the toilet where water meets porcelain, this is a sign that you are not absorbing fat and that SIBO may be present.

Dr. Davis says that many diseases can be seen as a symptom of SIBO. For example, he says 84% of people with irritable bowel syndrome have SIBO. People with autoimmune diseases, like Hashimoto's, Crohn’s, UlcerativeColitis, and rheumatoid arthritis, as well as those with neurodegenerative disorders, like Parkinson's disease, Lou Gehrig's disease, Alzheimer's, dementia, cognitive decline, or multiple sclerosis have a high probability of having SIBO. 

What is SIFO

It is also possible to have small intestinal fungal overgrowth (SIFO). The trick is that sometimes SIFO looks like SIBO and as a result, they are misdiagnosed. There are about 200 different fungal species that can proliferate in the small intestine. The symptoms of SIFO are tough to distinguish from SIBO but it's typically bloating, diarrhea, skin rashes, eczema, and sugar cravings. 

SIFO can take months to treat. 

The SIBO and Endotoxemia Connection to Depression

Dr. Davis says that people who are depressed may get temporary relief from antidepressants but he doesn’t believe this is the long term solution because the real cause may be SIBO endotoxemia. A German research group performed two studies in which they injected endotoxin into the bloodstreams of non-depressed people. The result was profound depression which was identifiable through MRI brain scans. 

Dr. Davis believes that, for many people, depression is a disease of the microbiome.

How to Support SIBO

If you talk to your regular doctor or a gastroenterologist, they’ll likely prescribe a course of conventional antibiotics. This is about 40 - 60% effective and can be very expensive. Plus, you run the risk of perpetuating the problem because of the damage the drug may do to the intestinal lining.

There are many herbal remedies that can work as well as the antibiotics and after that,  but Dr. Davis recommends high-potency probiotics that are best delivered through home-made yogurt or fermented foods. 

When supported properly, SIBO can be eradicated and it does not have to take many months.

Supporting SIBO with Home-made Probiotic Yogurt

In his book, Super Gut, he has recipes on how to ferment your own yogurt at home using specific bacterial strains. These recipes use the microbes like Lactobacillus Gasseri,  Lactobacillus Reuteri, and Bifidobacterium Infantis (commercially available under the name EVIVO). 

When Dr. Davis makes his own yogurt, he finds he’s getting upwards of two hundred sixty billion counts of bacteria, per half cup serving which is significantly higher than what you might buy as a supplement.

The benefit of this is that the right bacteria (in the yogu...