Agreed . This makes me highly suspicious of the company (Bio vis) transcribing the results of the Breath testing. By extension it makes me suspicious of the ordering physician if they haven’t recognized this problem with their testing partner before.
Studies show Statins are more likely to raise your lp(a) rather than lower it. By approximately 11%.
Genes are not Destiny, at best they are propensity. Try to avoid feeling fated. I also have Super-high lp(a). Freaked out until I got a coronary artery calcium score that showed “zero”. (At 60) It’s not a ct angiogram but it’s still re-assuring. Especially to think that a stable genetic marker like lp(a) has had 60 years to do its damage…. And quite likely hasn’t. Manipulate your phenotype to override your genotype.
Sure, to be clear I’m not arguing against the use of probiotics. I use them in my own practice (I’m certainly not close minded). I’m just curious about the method by which they are useful in SIBO cases (and they are) and not wanting to conflate, prematurely at least, the word “decontamination” with “killing. To be clear, from the literature I’ve read (and forgive me for not reading tge other 17 studies, I’m sure they provide greater insight) a multifactorial approach yields greater success than single silver bullets like xifaxin OR atrantil OR Neem… or probiotics. In my understanding it’s not an either/or prospect but rather a strategy. Perhaps “decontamination” than a strictly anti-biotic “kill-the-other”. Not looking for a wholesale “kill-shot” but rather altering the milieu/microBIOME ecosystem to facilitate more native (more health conducive) ecosystems within the entire lumen. Probiotics are definitely part of that strategy but something else initially serves as the anti-microbial approach. PRO-biotics come in after in a more resuscitative manner. Both contribute to de-contamination as contamination implies more pollution (of an ecosystem) than infection. As both siebecker and pimental have both suggested: these aren’t always “bad” bacteria they are just in the wrong space (small intestine) and need to be removed
I don’t know that I would interpret that as effective in “killing” SiBO but can’t argue that the researchers are actually using the word “decontamination” . I think it is a matter of staking a claim in the biological terrain whereby loading with probiotics that are more representative of a more “native” gut flora (e.g lactobacillus , bifidobactrria et al) muscle out the invasive (read:pathologic) species that are triggering broad systemic effects through mobilization of the immune system to bacteria it doesn’t recognize as “me” (or perhaps “mom”…. The bacteria that would normally / natively colonize are gut from travel down the vaginal canal at birth)
Completely agree with imothro on both accounts:
1) this is a moderate (not mild case… but also not in the class of worst). As you eradicate Methane-producers expect hydrogen producers to become unveiled as “worse” as the methane producers have been feeding on the hydrogen-producers hydrogen.
2) don’t listen to this HHH poster. They are babbling BS (stove gas !? as a cause of high methane baseline !??? ). I don’t think it is deliberately misleading at least I HOPE not … although I’m wondering about some other posters in the forum. Shades of Dunning-Kruger though.
David Haller according to the FX TV Series (Legion) or just straight from the comic ? I realize they are based on each other but the series actually invites fourth wall breaking and the shadow King is practically an eregregore all on his own , both Astral travelers. I’ve felt that art that encourages such an approach is more apt to provide results. The TV series makes a point of the earworm contagion of ideas as well.
Tinctures are the old pharmaceutical media in the west and were the bulk of “official drugs” in the United States Pharmacopeia and National Formulary as modern pharmacy was being taught in medical schools in the 1800s / early 1900s. This isn’t just “folk medicine” but it was born of folk traditions and then researched - same as Ayurveda in India and TCM in China They only fell from favor because you cannot patent a plant , but if you figure out how to synthesize morphine you can patent that …. And every pharmaceutical drug thereafter. We are lucky to still have researchers like Gerard Mullin at John Hopkins continuing to research herbal medicine as examples in this excellent 3-arm trial posted above where BOTH herbal arms of therapy out-performed the standard antibiotic therapy Rifaximin. How much more significant those results might have been if they had used standard pharmaceutical tinctures :)
The risk of the tinctures (just like their benefits when professsionally administered … ie by professional herbalists) are personalized as the whole premise of vitalist herbal therapy is customized formulation.
That said generally risks of tinctures are alcohol related. They should be considered contraindicated for anyone with alcohol abuse (especially for those of us who have taken the Hippocratic oath of “first do no harm”). Alcohol in other folks CAN contribute to “leaky gut” however that is a rare effect at typical therapeutic doses (also t get e GI tract is functionally “leaky” and “leaky gut” isn’t strictly pathologic besides not being a legitimate diagnosis anyway. I have seen severe cases of SIBO secondary to binge drinking episodes (the bachelor party) and in those cases I would also restrict the use of tinctures. People may also mention the alcohol sugars - the polyols-in some alcohols and representing the “P” in FODMAPS (advocating a low Fodmap diet) actually the net change is probably favorable in the final calculus as tinctures have low Fodmap / polyol content and at approximately 50-70% alcohol there is a greater antimicrobial result, where benefit outweighs any risk - whether leaky gut or Fodmap worries.
Nevertheless would encourage anyone to recognize stated contraindications for tincture use (ps glycerite tinctures are problematic but not hard contraindications and have often proven safe for patient populations dealing with alcoholism)
Only if sample number 7 is the one that takes you pass the threshold for positive after subtracting baseline It’s not likely a false positive at all if threshold is crossed by sample 6 or prior. Even sample 7 represents small intestine in most cases.
Herbs: Tinctures > pills / tablets / capsules.
I agree with most of this actually. I mean can you imagine the market he has cornered??? There’s a reason why one of his symposia was called something along the lines of “global IBS…. Yada yada” I mean his entire research is restricted to SIBO but rather than just staying in the lane he’s actually going after the entire IBS market rather than the narrower SIBO market … and the Global (world-wide) market at that.
I’m torn however because he DID do the bulk of the research that has put SIBO on the map. People have been brutalized by their doctors for decades prior. He’s nearly single handed taken it out of the realm of “Syndrome” and into legit Diagnosis …. But his pursuit of the IBS market in its entirety (notice the Rifaximin commercials are geared toward IBS NOT SIBO even though it’s an obvious antibiotic) did no favors for the community….. so now, as with the study above, SIBO itself may get relegated to the same disregard by doctors as IBS has as a “psychosomatic” condition.
Would never deny a patient’s positive experience with any therapy. This is a very heterogenous enterprise. The problem with Western medicine is this top-down attitude of one-sizes-fits-all. The (hopefully) new trend in healthcare will be patient-centered with an intentional honing of the provider’s ability to identify (sooner rather than later) which interventions will work best for the patient in front of them with the goal of a quicker resolution. My personal bias is for customized formulas for all the different varieties of sibo. Remembering: one’s microbial gut mix is as individualized as a fingerprint. This is a condition that begs for bottom up (clinically contextualizef) rather than top-down (institutional) approaches.
Admittedly, I have not read this article yet…. But I have been anticipating it for years.Quite simply- “the backlash”
I HAVE read the title of the paper and note that the response is more aggressive than even I expected. My personal take is that this is a deliberately negotiated position paper “endorsed” by two associations (European/America) presenting a united front as a bulwark to industry. The goal here is not the honest parsing of the evidence (I suspect) but a rallying call for ranks of gastroenterologists to fall-in lest they see their entire industry overturned.
No less a paradigm shattering genius than Lynn Margulis warned about entrenched “thought-collectives” incapable of evolution when income depended on it. She was only having to deal with academic research institutions. Not quite as entrenched as medical industry. To this day people are still raging (stupidly) against her Serial Endosymbiotic Theory- even though it is now accepted as established fact based on the flood of supporting evidence since then.
This is really a sad response by industry. PAtients will undoubtedly suffer and will continue to be told that their condition is “psychosomatic” which honestly -it is! - just not in the manner that the doctors mean it (“it’s all in your head”) when they say it.
We should probably take a moment to remember that in social media , typically the folks that stick around (have to!) are the ones that don’t get resolution of their condition and will likely have an outweighed presence in the threads. All the folks who got better have simply moved on with their lives, Sadly they may not be around then to encourage others who are having a more difficult time of it. Admittedly, sometimes those people that aren’t getting better HAVE been misdiagnosed (although my suspicion is that in more cases they in fact some other additional diagnosis that remains untreated and remains as an obstacle to cure)
Will be reading this article this weekend very closely. Again this is a dual endorsement by a “thought collective” incentived to preserve the livelihoods of its members. I’d bet the authors are earnest and sincere however suspecting that this represents an effort similar to Radio Free Europe. But Naturopaths (herbalists) are not their enemy … even if their incomes are threatened.
Totally agree. Also Dr Pimentel is going to be at the vanguard of the defense here and his associations with Starlix research on Rifaximin, his market capture association with Trio-smart and his rollout of IBSchek or whatever it is called today will be trouted out as exhibit A/B/C in a potential smear campaign based on a “conflict of interest.” I can only imagine the enemies he has made threatening to overturn an entire medical industry of gastroenterology with a simple cheap breath test (vs EGD/colonoscopy)
Just curious - were all of your breath tests performed by CommonWealth Labs? I used to use them for my patients but the preponderance of reports were coming back negative. (False negative , I’d say) Nevertheless I treated my patients based on symptoms of SIBO and they would generally feel better - some with symptom resolution early in treatment others later and admittedly some not at all (this could have been due to treatment failure OR mis-diagnosis on my part ….. neither of which proves that the SIBO “hypothesis” is a clinical Non-entity. Which, let’s be honest, many (many) gastroenterologists will quickly default to that conclusion and point to this paper for back-up. And they will be calling for back up - their entire industry of colonoscopies and EGDs , tge bread are the butter if you will, is being threatened and this includes revenue for hospitals as well.)
Tbh, professional herbalists look at the ingredients in the label and just shake their heads. Herbalism as practiced by a western trained M.D. Honestly the formula makes ZERO sense . Quebracho ? C’mon, man. The mint may work as a carminative but any mint will do that - certainly no reason to pay exorbitant prices (and no , there’s nothing special about that mentha… it’s just novelty marketing) . As with anything in the Sibo realm some things will work for some people. The horse chestnut is used traditionally for colonic inflammation and would be used in Crohn’s or U.C. Scenarios
Glad it is working out for you ! Sounds like you are on the right path. Yeah, I sure as heck hope we aren’t devolving into arguing. My only real point was just a cautionary statement that it’s prolly best to talk about what has worked for “me” (regarding diet) and not extrapolate that into discussions about “Your” diet (“doesn’t make SIBO worse or better”) . In 30 years of practice if there is one thing I have learned about medicine is that there is definitely NOT one-size-fits-all , so I generally have a knee-jerk reaction to absolute statements like that. People already get that attitude from their doctors. It seems terribly unhelpful in health forums on Reddit and especially SIBO.
As an aside: Regarding dietary advice in general and attention to scientists , researchers etc…. Diet research is incredibly hard to conduct , basically requiring a metabolic ward with a forced diet regimine for ALL patients enrolled in the cohort and extended over many months in order to tease out a meaningful signal. This understanding qualified my initial reaction to your comprehensive SIBO guide and the diet studies included. Most research studies on diet are weakly observational and not interventional like tge metabolic ward studies that are necessary. Really they should be taken with a large boulder of sal
As an example here : is a breakdown of three Keto Diet studies from published journals that was just uploaded onto YouTube just 3 hours ago by one of my favorite new diet researchers. He’s a 3rd year Medixal Student at Harvard but got his pHD in biochemistry from Oxford (in 2 years) and cured himself of Osteoporosis and Ulcerative Colitis ….. with Diet.
So that’s an obvious “straw man argument” - suggesting I don’t “trust scientists and research and studies”. I absolutely do (I am one). The complete reactionary dismissal is a bit telling as well. But no , you are correct , you DON’T need my approval (but neither was I suggesting that you did). I was merely trying to help by suggesting that diet is not likely a healthful approach for you and wanted to encourage that path for you. That sort of sharing is what this forum is about - so just sharing that opinion. Wishing you the best on your healing journey and YOuR life as well. (FWIW , I haven’t had SIBO for years , FWIW diet was a major factor in that journey…. YMMV.)
Thanks for that detailed follow-up. Sounds like he is absolutely on the right path now!
It’s so heart-breaking hearing all of these stories of general dismissal from the supposedly “best health-care system in the world”
There is a real reckoning on the horizon because of this condition
I read that, thanks. Cherry picking ressources to support you PERSONAL hypothesis does not Qualify you to write a “comprehensive” guide.
Wondering where this absolutism was coming from I decided to read your post history in other threads . Just going back 9 days ago told me everything.
I really DO wish you the best of luck on your healing journey.
AND (more importantly perhaps) I DO think that Diet is definitely not tge appropriate approach to SIBO …. for YOU.
I’m trying to be considerate but honestly you are new to this and I’m worried your absolutist declarations above could do more harm than good … for others.
I do recognize that you are getting a lot of positive feedback in other forums but honestly in my opinion that’s just the nature of health threads in Reddit where people are desparate to hear absolute statements of “cure”…. ESPECIALLY if it means they don’t have to even worry about diet at all
Glad he is having such a solid path to recovery! Glad you found a locally competent doc.
Pardon my query but I’m just wondering if what he was dealing with all along (SIBO) was just getting mid-diagnosed by previous docs as a “VIRAL gastroenteritis”? You would not believe how often this misdiagnosis of SIBO occurs in the younger population. Honestly, though I believe it may be motivated by good intentions: the doctor knows that repeat rounds of antibiotics at such an early age very poor antibiotic stewardship - so they feel the need to diagnosis a viral cause to avoid the parental pressure to just prescribe (another?) anti-biotic. Just something I’ve noticed in my own practice. Not suggesting it’s universally true for all cases. Wishing your son a sustained recovery!
They won’t all be running at the same time. One will get the nomination and then the party (and Independents and never trumpers) close ranks. Will some Dems pout because the replacement candidate isn’t the one they wanted . Sure, maybe some but already over 2/3 of polled “Biden voters” have already said they are voting “against Trump” NOT “for Biden” so they don’t even care who the candidate is. I’m one of them
Gov. Andy Beshear responds to calls to replace Joe Biden in presidential race
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