Can a Short-Term Elemental Diet Help Treat SIBO?


This is a guest post written by staff nutritionist Kelsey Marksteiner, RD. Click here to read her blog or join her newsletter!

For those with small intestinal bacterial overgrowth (SIBO), the symptoms can sometimes be unbearable. Bloating, gas, diarrhea, constipation…the list goes on. While simply getting diagnosed in the first place is half the battle, when it is diagnosed, how do we treat it? If you’ve tried some of the options out there like rifaximin or herbal antimicrobials with no luck, what’s left?

What is SIBO?

Before we talk about treatment options, it’s important to know exactly what SIBO is. Small intestinal bacterial overgrowth is exactly what it sounds like – an overgrowth of bacteria in the small intestine. Normally, the small intestine has very little bacteria compared to the large intestine, which houses most of our gut bacteria. However, bacteria from the large intestine can translocate to the small intestine under some circumstances, leading to the development of SIBO. There are many underlying factors that relate to this translocation, including low stomach acid, pancreatic enzyme insufficiency, and intestinal motility disorders, among others. (1)

The usual treatment of SIBO can include diets like the Specific Carbohydrate Diet (SCD) or the GAPS diet (usually in combination with a low-FODMAP approach), antibiotics or herbal antimicrobials. (2) The SCD and GAPS diets help reduce the bacterial load of SIBO, but it can take a long time for dieters to feel significant improvement in their symptoms without the addition of other helpful treatments such as antibiotics or antimicrobials.

Rifaximin, the the antibiotic most commonly used to treat SIBO, is expensive, thus many patients cannot afford treatment. These patients may choose to forgo antibiotics completely and opt for natural antimicrobials such as oregano oil or berberine. These can be very useful in eradicating SIBO, especially in combination with a low-FODMAP SCD or GAPS diet.

However, I’ve had more than one client claim that they can’t tolerate the herbal antimicrobials. For these people, waiting months to over a year for relief with the SCD or GAPS diet can seem like eternity, yet they feel as though they don’t have any other options to try. Others have tried antibiotics or antimicrobials and failed. This is where the short-term elemental formula can be helpful.

What is an elemental formula?

In the simplest terms, an elemental formula is one that contains pre-digested carbohydrates, proteins, and fats. This means that it is absorbed very quickly from the digestive system. This is key for those with SIBO as we don’t want food sitting in the small intestine, where it would be used as fuel for the unwanted bacteria living there. Instead, an elemental formula provides a way to nourish the patient while starving the bacteria. When implementing the elemental diet, the patient will drink the formula instead of their regular meals for two to three weeks, depending on their case.

How effective is it?

In a study using the elemental formula Vivonex Plus, patients were instructed to consume only the formula for 14 days. On the 15th day, they were re-tested for the presence of SIBO. Remarkably, 80% tested negative. Those who were still SIBO-positive were instructed to continue the formula for another 7 days, after which the cure rate went up to 85%. (3)

So how does this compare to the other SIBO treatments I discussed above (rifaximin, herbal antimicrobials)? Though figures vary for the efficacy of rifaximin, the majority of studies I’ve seen estimate it to be around 50% effective, but some studies show even lower rates. (4) One study in particular showed the cure rate for rifaximin to be 34%, while herbal antimicrobials were more effective at 46%. (5)

An 85% cure rate for a three week elemental formula diet is impressive and should certainly be considered as a treatment option for those with SIBO. However, that doesn’t mean that it’s for everyone.

What are the drawbacks?

There are definitely some downsides to the elemental formula. First, and probably most important in terms of compliance – it tastes pretty nasty. A patient has to be willing to stick it out for at least two weeks (where we get the 80% cure rate) and potentially up to 3 three weeks to see results. While this doesn’t sound that long, it can  be tough to stick to when the drink doesn’t taste so good! This means that anyone about to try this treatment has to be very committed.

Second, typical elemental formulas are not what we’d call “real food”. Vivonex, produced by Nestle, contains the following ingredients:

Screen Shot 2014-07-14 at 5.34.12 PM

That said, you can make your own elemental formula if you choose. If you’re interested to see what goes into a homemade formula, check out this recipe from SIBO researcher, Dr. Allison Siebecker. Both homemade and commercial elemental formulas are expensive (though less expensive for most than a course of rifaximin), which is also a barrier.

Also, for those who are underweight already, embarking on a two to three week elemental diet can cause them to lose even more weight. This is potentially dangerous, thus an elemental diet should be very carefully implemented or not implemented at all in those who are underweight. Whether you’re underweight or not, an elemental diet should always be implemented under the supervision of a medical professional.

An elemental diet is also a short-term fix. SIBO is a condition that recurs frequently, thus during and after any type of treatment for SIBO, it’s imperative that the patient addresses these underlying factors to prevent future SIBO episodes. This means that those looking to an elemental diet to solve their problem forever still have a long road ahead of them after completing the diet.

Lastly, we’re not sure how it affects the rest of our gut bacteria. Does it starve the bacteria in the large intestine? If so, to what extent? We just don’t know, and only future research can tell us.

Chris’s experience

I asked Chris to share his experience with elemental formulas with me for this article. He responded:

“I created my own elemental formula, back when I was still struggling with my own gut issues. While it did reduce bacterial overgrowth, it seemed to exacerbate the fungal overgrowth problem I was also dealing with. I developed a thick, white coating on my tongue and the symptoms I associated with fungal overgrowth worsened. I also experimented with it in my work with patients with SIBO early on, but I found that compliance was low (because even the homemade formulas are pretty gross) and the SIBO tended to return soon after the patient started eating real food again. Nevertheless, elemental diets may have a place for patients that don’t respond to anti-microbial treatments (whether botanical or pharmaceutical).”

When to consider an elemental formula

There certainly are benefits to an elemental formula, namely its short duration (2-3 weeks). This is equal or one week longer than a course of rifaximin (14 days), and potentially up to four weeks shorter than a course of herbal antimicrobials, which are usually given for 4 to 6 weeks. Its effectiveness is also quite good (80-85%) compared to other treatment options. It might be worth considering for someone who doesn’t want to take antibiotics but wants a short treatment period, or for someone who has tried antibiotics and herbal antimicrobials and failed. It certainly wouldn’t be my first choice of treatment if I was going through it (mostly due to the taste and lack of real food), but if I had trouble with some of the other options, I’d certainly consider it. It’s a careful decision that one should make with their medical team and not something to take lightly, but its 80-85% cure rate deserves a look. Hopefully reading this article has made you think about the pros and cons of an elemental diet and allows you to make this decision more easily!

Now I’d like to hear from you. What do you think about elemental diets for SIBO? Do the positives outweigh the negatives or vice versa? Have you tried an elemental diet?


kelseyrd03This is a guest post written by Kelsey Marksteiner, RD. Kelsey is a Registered Dietitian with a Bachelors degree in Nutrition from NYU and a Master’s in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. She is a firm believer that everyone is different, and she tailors her plan for each and every individual. Through her work, she aims to meld the dietary wisdom of traditional cultures with the latest science in integrative and functional medicine to create plans for her clients that work in the modern world. You can learn more about Kelsey on her staff bio page, or by visiting her private practice website. Join her newsletter here!

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Comments Join the Conversation

  1. Shayna says

    Hello All,

    I have gone 13 years with the on and off symptoms of IBS, reflux, bloating and what some doctors thought was gallbladder pain. Numerous tests and medications have not fixed this problem. About three years ago I was finally diagnosed with H-Pylori and did a 14 day treatment of 2 strong antibiotics which seemed to make some what of a difference but recently I had to start taking new medications for a pinched lumbar nerve which then seemed to stir up some stuff in my gut again. With a recent negative test for H-Pylori I find myself wondering what is going on in there and now I am sicker then ever. I cant or don’t feel like eating much and when I do get my appetite back for a day and eat I become very sick again. Went to a new gastro and he basically said he had no clue and didn’t think we would ever resolve my issues. So I have taken it upon myself to self diagnosed this SIBO and am going to try this diet to see if it helps. I was wondering if anyone else has skin problems due to this condition? I get hives and extreme dry skin. I am also planning to try the iodine because I have a thyroid condition as well. Any advice or positive outcome stories are much appreciated and I will keep you all updated on my progress as well. Thank you all for your info on here it may have changed my life!

    • Shasta Michaels says

      I feel your pain! Try contacting a naturalpath doc that specializes in SIBO. Unfortunately I had contacted three and never got responses from any of them so I self diagnosed, which for me was my only option but it’s better if you can get professional help. I’m convinced that regular docs and gastro docs won’t help much. I don’t think they have the training and knowledge but this is my opinion only. I tried contacting a gastro and they wanted to charge me vast amounts of money for consultations to decide if I needed a SIBO test. Then were going to charge me again to come in and take the test. So I just ordered my own and skipped the doc! Also ordered my own stool test that showed overgrowth of three bad strains of bacteria. Also addressing estrogen dominance and I started taking the iodine as well as selenium for the thyroid. In my case, everything is coming together but your case may be vastly different. I do think you should try a natualpath that specializes in SIBO, they just have more knowledge and look into underlying issues, not just treat symptoms.

      This discussion list has been a huge help to me so use it! Keep us posted and do your homework until you are sick to death of reading about SIBO! Also check out this website and the IBS version of the book they refer to (Fast Track Digestion IBS). I got the book used on amazon and the diet approach is a lot better than the popular diets recommended for SIBO. I’m having very good success with it so far and it seems like it’s been the best approach, the other popularly recommended diets like FODMAP and the carb specific diets aren’t quite right for the condition. If you have an Amazon Prime membership you can “borrow” an e-copy for free too. Also, the FAQ section on that website will answer a lot of questions not addressed in the book.

      • Shayna says

        Ok so here we go today is day one on the elemental diet. I hope this works. My plan is to do this for 3 weeks. I will keep you all updated on how I am feeling in a few days. :)

        • Shasta Michaels says

          Good luck and stick with it! It’s hard at first but worth it. And be sure you are taking a biofilm disruptor and the right herbals, rotate the herbals every four days to prevent resistance. If you start feeling flu-ish and sick, drink lots of water, this is toxins from killing off bacteria and it’s not fun! But stick with the diet! It’s a sign that it’s working! Get plenty of sleep too. Keep us updated on your progress!

          • Shayna says

            So I started my first day on the 21st, took the first drink of my mixture and then threw up 4 x. I realized I wasn’t going to be able to drink that stuff unfortunately. I waited till after the weekend and started my own fasting diet. I consumed one to two cups of chicken broth with coconut oil added to it and tons of water. I also have also been taking the multivitamin’s I purchased for that god awful drink. Now I am on day four and I feel horrible. I cant drink anything but water and I feel exhausted. I hope this will work still because I cant go on living with these stomach issues like I have for 13 years. I am going to try to do this fast for 14 days but if I don’t start feeling better soon I fear I wont make it that long. Also Shasta I am not familiar with the biofilm disruptors or herbals you are talking about. If they are costly its going to be hard for me to get them because I already wasted $160 on stupid amino acid powder I will never use. How long were you extremely sick for? I am really hoping this gets easier tomorrow or the next day. Any other advise is much needed and welcomed.

            Thanks Again!

            • vb2005 says

              Hi Shayna,

              Have you tried dextrose or glucose – according to Fast Tract Diet for sibo – it is rapidly absorbed and bacteria dont have time to feed on it – it rises blood sugar rapidly but can be taken in small doses. It tastes very good and gives you carbs – without carbs your thyroid will slow down. I think dextrose is the main source of energy in some elemental formulas. Also if you have sibo probably your small intestine is damaged and you can not digest fats – so maybe coconut oil make you feel so bad.

              • Shayna says

                Hi VB,

                I am on day 5 now of basically fasting because I have been so sick to my stomach I don’t want to eat or drink anything but water. I thought by now some of my gas and nausea would subside but I am still having a lot of both. I am trying really hard to just stick to this fasting till next Friday and then I am going to start introducing some food back into my diet. I think I am going to try fish and veggies that are low carb and don’t cause gas. I find the more I read about SIBO the more complicated it seems and I feel really down because I think I will never feel better, maybe I feel that way because of the lack of food but it is a real fear for me. I desperately want to feel like I used to when I didn’t have all these issues. If this doesn’t work I am going to go back to the doctors to see what they can do but I don’t have much faith in them either as I have been dealing with this for 13 years with no resolutions.

                Thank you for checking on me all of you :) and happy Friday!

                • Kim says

                  Hi Shayna,
                  If you have SIBO/IBS-C there is a supplement that was developed by a GI based in Plano, TX that you might try. It’s called Atrantil. It was just released this summer. You might check it out. I’ve been on it 6 days. I felt worse after I started it but am a bit better now. SIBO is so overwhelming on so many levels. The Dr.’s just don’t know enough yet.
                  I do hope you feel better.

                • Shayna says

                  Not feeling better at all and I am getting very discouraged. Going to wait another week before I call my Dr. :(

                • Shasta Michaels says

                  You WILL feel sick for a couple weeks, depending on how much bacteria was overgrown in your small intestines. You’re probably experiencing die-off, which is all the toxins released from killing those nasties off. Hang in there. I was knocked on my butt for a full two weeks when I did the elemental. Hang in there. It means it’s working. Are you taking herbals to help kill stuff off?

                • Shayna says

                  I am really trying and I am going to try to make it through the week and see how I feel but the pain I’m getting in my diaphragm area through to my back is getting so bad. Does anyone else get his pain? I am not taking any herbals but a friend of mine gave me the name of a specialized herbal store in my area and she said the guy that works there is very knowledgeable so I am going to try to get over there sometime this week and see what he says. I just really need to start feeling better because this is starting to ruin my life :(

                  Thank you for the pep talk Shasta. I am going to try my hardest.

                • Shasta Michaels says

                  Try to find a doc familiar with SIBO before setting an appointment. I had to see a doc on Friday for a different issue and mentioned the SIBO and he looked at me and said “What’s that?”. Never heard of it in his life. I suggest a naturalpath, they seem to know more. Ask questions before going though, make sure they know what they’re doing. The medical industry doesn’t seem to recognize the condition yet. As for the herbals, do your homework. I rotated herbals every four days, and used two at a time. This helps keep bad bacteria from adapting to it.

                • Shayna says


                  I just feel exhausted by all this my head is spinning from all the info I have read and talked to you all about. I don’t understand why there isn’t a easier way to get better :(

                  I will definitely take your advice about the dr because I went to one who was a complete moron and tried to get me to take a stronger antacid that cost $195 a month, after insurance, even thought I told him I wasn’t having reflux symptoms. I will never go back there.

                  Thanks again!

        • vinny puri says

          hi shayna you must be on day 7 of the elemental diet (vivonex?)
          my niece is starting it today for SIBO that didn’t respond to antibiotics very well.
          We are doing it through a tiny nasogastric feeding tube to avoid the taste.

          how are you doing so far?

  2. Shasta Michaels says

    Hi All,
    I’m currently on the elemental diet and herbals for SIBO….self treating because of money. Test confirmed SIBO and I’m seeing a difference already, although this is the most disgusting nutrition I have ever consumed in my life. I’m going to stick this out for four weeks, I have a pretty damn good case and also wish to heal leaky gut. With that said, can anyone give me some advice on how to reintroduce solid foods back into the diet when the time comes? I’m one week into this so far. Other than the extreme exhaustion, initial feeling rotten from die-off, and not being able to lift weights while I heal up my gut, I am happy with how things are going. I have decided to add organic bone broth on a daily basis as it is excellent for healing leaky gut. Anyway, really want to know how to reintroduce solids and I know I’ll have to be a bit careful….how did you all do it? Any advice is much appreciated. –Shasta

    • NSum says

      Shasta I did the Elemental fast a year ago. I did it for two weeks under my Naturopath’s supervision.
      It is important that you use some sort of intestinal stimulator afterward as well as a very good probiotic. I use a soil based formula I heard about on this site. I really truly notice the difference when I stop using it (due to forgetfulness mostly). I actually notice the difference when I restart because of the tapering off effect, once I restart everything works better.
      If you do not follow up with these digestive helps you are more likely to have regrowth. Most likely due to my sloppiness I had a regrowth and am facing another fast.
      I was very conscientious about food intake. As well as following the limited diet suggested on siboinfo(dot)com, meals must be spaced 4-5 hours apart. This is 90 minutes for digestion and another 2-3 hours for an intestinal flush. Your body does this flush if it has enough time and it is very beneficial for gut health. Yes, you may be hungry. You need a lot of water anyway and drinking it between meals helps with hunger. Sarah Ballantyne’s Auto-immune protocol is very helpful and the cookbook is annoted for different dietary needs, including low FODMAP.
      Good luck and don’t be too discouraged by the frustrating diet. You aren’t alone and many people are sharing recipes online now.

      • Shasta Michaels says

        I did the elemental for 4 weeks and had amazing success with it! Yes, I’m still on something for motility and doing all the right things, even still on a very small amount of the herbals and medical grade manuka honey once a day (and a biofilm disruptor) just as a preventative measure and I rotate the herbals and honey every four days so any bad bacteria has less chance of building resistance.

        FODMAP is popular for SIBO but isn’t quite correct. Check out this website and get the IBS version of the book, this is what I’m on for my meal planning and so far it’s amazing… approach to eating for SIBO and is way better than the other popular/recommended diets out there.
        I got a used copy of the book off for $8 and if you are a Prime member you can “borrow” an e-copy if you wish to read it first at no cost. This diet concept allows certain carbohydrates based on their fermentation potential in the gut and the approach has proved to be WAY better than FODMAP and carb specific diets, etc. Makes total sense to me and so far is working very well.

        I’m a bodybuilder so I have to eat between 5-7 times a day anyway…..right now I’m still ramping up on food intake and being very careful so I don’t do anything to relapse but as it stands, all systems are go! I lost a lot of muscle mass on the elemental since I didn’t workout while I was on it and allowed my body to just focus on healing, but I’m back in the gym and seeing results in less than a week. I honestly thought my bodybuilding was over because so many SIBO diets just eliminate the necessary carbs that are important to bodybuilding. So needless to say, I’m overjoyed! Will be in a sort of ramp up mode for a couple weeks but I’m ok with that. And really, this book I mentioned touches on athletes like myself and carb intake……the intensity of my fitness may actually help me with all this because once I’m back to 100% my body will process food much differently than the average person and digest things faster, less to sit in the intestines. Talk about win-win! WooHoo!

          • Bonnie says

            Hi Jen
            I found that Iberogast made me a bit hyper and that might be from the Licorice that feeds the Adrenal glands. Guess how I increased motility? A THYROID PILL did it for me and noticeably within a few weeks as I increased. After 8 miserable years with bloating and nausea, I’m very happy now.

          • Shasta Michaels says

            I’m using a product I get off called MotilPro made by a company called Pure Encapsulations. It’s ginger extract. Been working for me very well. In fact, I had sort of slacked off on taking it a little, not stopped entirely but had spaced a few doses and the SIBO seemed to be acting up again. Upped the dosage and literally in 24 hours I was back to normal. It sorta burns a tad if you don’t drink enough water when and after you take it, but up the water intake and no issues. I had read reviews and people had good luck with it, found the reference to it on a different SIBO site I believe. So I think I definitely have a motility problem.

        • Kim says

          Hi Shasta,
          Thank you for all that you have shared. Would you mind sharing exactly what ingredients you used on the elemental diet? Did you follow the recipe on I know in one of your posts you mentioned adding pea protein so you wouldn’t lose so much muscle. It’s so great to hear that you are feeling better! I think that unless one is lucky enough to live near a doctor that understands SIBO we are dependent on what we can learn from others on blogs like this. Thanks so much for sharing your journey. If you’ve had good luck with some specific supplements I’d love to hear about them as well.

          • Shasta Michaels says

            Yeah, I’d do two scoops (teaspoons) of the nasty amino blend, a scoop of pea protein, and about 20 grams of dextrose. Oh, and 5 grams of L-glutamine per shake. As cold as you can get the water. Chased with some MCT oil and a spoon of honey. Tasted a lot less like vomit that way, the amino blend is brutal on the taste buds…..seriously gross. Most people aren’t going to need quite as much protein as I used but it won’t hurt you, I needed it.

            For supps I rotated herbals every four days: neem, peppermint, grapefruit seed extract, berberine, oregano oil, and allibiotic. Pick two and only did those two for four days then rotated to another two. This keeps the bacteria from adapting to it. Also, I always took a biofilm disruptor 15-30 min prior to the herbals. I took a ginger extract supp three times a day for motility. And I took a spoonful of medical grade (16+) manuka honey at night. This stuff will kill the MRSA virus and every other nasty under the sun and helps with digestion and healing. (also used manuka to heal an infection from a cut that my dog had, it cleared up the infection in 18 hrs by applying it topically with a bandage, really good stuff!)

            I’m also doing 4-5 drops of the Lugol’s iodine that was suggested on this page and selenium. I have continued the herbals but just once a day, still with a biofilm disruptor.

            Last, for leaky gut I drank a big cup of beef bone broth every night before bed. I get mine at a local organic butcher shop that makes it to standard for gut problems.

            I stayed on the elemental diet for four weeks and the bloating, swelling, inflammation, and water retention that I’d been experiencing for two years (really bad this past year) totally vanished! I recently slacked off on the motility supplement and started bloating again, but got that under control in a matter of 24 hours with the supp so I won’t be making that mistake again! I occasionally go to a sushi restaurant and buy the pickled ginger and munch on that as much as I can or use it on meats.

            Last, I’m telling everyone about the Fast Track diet I discovered. It’s way better suited for SIBO than the other popular diets like FODMAP or GAPS or that carb specific diet. check out this link:
            There are two books referred to on that link, you want the IBS book, it can be “borrowed” for free with an amazon prime membership and I bought a used copy for $8. It’s had a huge level of success with SIBO sufferers and it’s working for me very well. The theory on carbohydrates is the fermentation potential of a particular food….in other words, how long it’s gonna sit in the digestive tract. I can eat carbs!! This means I can still bodybuild!! Other diets are like “cut out carbs!” and I can’t do that if I want to bodybuild so it was causing me high levels of depression thinking I had to give up something I dearly love. Gotta have that fuel for my level of workouts! Further, I don’t think it’s healthy to cut out all carbs and green veggies aren’t enough for me when it comes to this area of nutrition. What can’t be found in the book can be found on that website under the FAQ section
            Serious life saver! This allows more variety for sure!

            • Shasta Michaels says

              P.S. Just for the record, what I did NOT anticipate with the elemental diet was how sick I got the first week in particular. The flu-like symptoms from die off was wretched! But I had a bad case. I’m very lean…..less than 15% body fat and I looked close to 7 months pregnant most days. It was bad. My belly is now flat but I do suggest that anyone who does this plan for it better than I did, I should have stayed home that first week. Also be prepared for bouts of very low energy and be sure to get enough sleep at night. You’ll also get horrible brain fog. Maybe if someone’s case isn’t all that bad the die off won’t be either but mine was horrible. Stay as stress free as possible while you heal. Get moral support for the depression you could experience and stick with it! Drink a lot of water and listen to positive, uplifting music. I was alone on this journey, friends abandoned me (it’s all good when things are positive and fun but some friends vanish when you need moral support). I think these aspects were the hardest part of the diet, they literally made the nasty shakes the easy part. At least for me.

              • Shasta Michaels says

                P.S. again. I keep forgetting one critical “supplement” that I started using. I don’t know why this works but it did. Monster Lo-Carb energy drinks. Somewhere around the 3rd week on the diet I started to crave those things horribly, which is out of character for me. I was off caffeine so I knew I wasn’t craving that but I HAD TO HAVE A MONSTER DRINK! No kidding, within the first two days all my remaining/residual bloating and inflammation vanished almost overnight and I felt WAY better. So I’ve had one every day. At this point I really don’t want them anymore so I’m tapering off but still have them a little. I had also noticed this about a year ago….a couple times I fasted and had a Monster lo-carb and felt WAY BETTER. I don’t know what’s in them that makes a difference for me but I suspect it’s either the taurine or the B vitamins. I’m now on supps for both those and maybe that’s why I don’t crave the Monsters anymore. Yeah, I know they aren’t the best for a person but for whatever reason they most definitely helped me. If anyone has any ideas why, I’d be interested in hearing your take on the matter.

                • Kim says

                  Thanks so much for all this great information! I appreciate you taking the time to post so many details.

        • NSum says

          Prescript-assist Broad Spectrum Probiotic Prebiotic Complex. I bought it online from a couple of different sites. I like to price compare. I am currently getting it from amazon but am too busy to shop and amazon is easy. (Tightly closing the moral dilemma amazon marketplace can of worms)

    • Jen says


      Can you tell me:
      What you are taking to increase gut motility?
      What do you take to be a biofilm disrupter and herbal aid?

      I am pretty desperate with SIBO and bad IBD (both). I am awaiting the results of my Genova stool test this week as well to clarify what bug is really in here! I am not sure if Ishould do Lugol’s or an elemental diet.

      thank you.

      • Bonnie says

        Jen, why not give Lugol’s Iodine a chance? I had at least 3 pathogenic bacteria on a stool test in high amounts and wanted to get rid of them fast. I was so sick for 8 years and within 3 weeks at 3 drops per day, I noticed all nausea left and never returned and that was 4 years ago.

        • Jen says

          I am willing to try Lugol’s. I have had constant weight gain for two years where my DHEA and cortisol and female hormones went all over. I have UC and Crohn’s and leaky gut etc. I feel I cannot eat and veggies anymore–im down to meat and fat..You think I would lose some weight!! All i crave is grassfed meat and butter and coconut oil I am not sure why? I am on Armour thyroid already but have seen zero change…sill all FreeT’s are low normal and my TSH went from 1 to 2.1?? So odd,

  3. Brooke Dupont says

    Bonnie –
    Thank you so much for mentioning Your Thyroid in your post. My husband has been suffering with what seems to be extreme SIBO for the last 8 months, he has lost over 40 pounds and has been lethargic, extremely fatigued, depressed, had anxiety and is constantly in a brain fog, we saw 3 different physicians (MD) had tons of blood tests and procedures done and we saw one naturopath (ND) We were able to get the SIBO diagnosis from the naturopath dr and Justin started the very strict diet and herbal antibiotics (berberine, garlic) but after re-testing 3 months later his results barely improved. We just went to the MD again this week and asked them to please test his thyroid after reading your post. We could not believe they had not tested it before with how sick he has been, he was even hospitalized at one point, you would think they would have checked everything while he was in the hospital but I guess not. The results came back from his Dr. Appointment this week and he has Hypothyroidism. Now we just need to find a good quality endocrinologist to work with to get it regulated, but I am confident that once we are able to do that the SIBO is going to be a lot easier to deal with. Thanks again for your post and all of your valuable information. It really could be the key that helps get him back on the road to recovery.

    • Binnie says

      Brooke, I’m thrilled to have helped in some way AND surprised again that this can happen to people. Once you make that connection (or someone makes it for you) life returns to normal but not for everyone. To me this is just the beginning.
      Hopefully your doctor won’t just test the TSH as mine did. I had to go to another who does all three thyroid tests. And also I was prescribed Armour in the beginning, a commercially made product. I didn’t want to take a synthetic like Synthroid. I then could not tolerate the FILLERS in Armour so had to have it compounded with Glycine at a Pharmacy. Then the capsules they used (Avicel) which is made from WOODPULP was a problem. Finally they switched to a Vegi capsule and all is finally well.
      I never saw an Endo, this was done with my GP who was okay with leaving me at one Grain. I asked to have a requisition sent to me, got the results from a blood test, put my results online with a thyroid group and was told the numbers were too low. Increased again, waited 6 weeks, did another test, still too low. I am now taking two grains and testing once more next week. You will have to be a big part in this process to get his test results where they should be and maybe that is where an Endo can help. Not sure but in the beginning before I found Thyroid I had such a load of bacteria, that the nausea was overwhelming. Thankfully I found Lugol’s 5% iodine and within 3 weeks at 3 drops per day, that was gone, but I still take it for all the other benefits. If you have any questions, be sure and write and good luck. Bonnie

    • Bonnie says

      Hi Brooke

      I just happened to see your reply here, looks like I missed it. I am very pleased to have been some help to just one person, since I’ve been writing here about Iodine KILLING bacteria in the gut for close to a year now with little success. I think your husband would feel better FASTER with a bit of Iodine to get the bugs killed off, even before the Thyroid kicks in.

      • vb2005 says

        Ho Bonnie,

        I wonder is there any special reason to take Lugol for iodine – why not take kelp for example? It seems one drop of 5% Lugol have 5.0 mg iodine so – i have a bottle with Kelp capsules – each one capsule have 360 mcg of iodine – if i begin with one and get to 10 -15 capsules par day – this makes 3.6 mg 5 mg per day it should work. I mean kelp seems more natural to me but iodine fans seems to use Lugol.

        • Bonnie says

          I would NOT take any form of seaweed with all the Radiation that is now in the ocean from that Japan spill. It is all polluted, it reached the shores of California 2 years ago, so it is now EVERYWHERE. I don’t know how you can say that is natural. Lugol’s 5% Iodine is made in a lab, the same way it was made in 1818 (or thereabouts) by Jacques Lugol and before antibiotics in 1936, Lugol’s Iodine was the only thing available to doctors and fixed a lot of problems. One drop of Lugols 5% is 6.5 mg. For a year I took 16 drops per day and had the most amazing results which I’ve written about before. If you want to take 20 capsules of seaweed per day, you may be disappointed but with Lugol’s you get results.

  4. Jen says

    What if you have sibo and slow motility but keep gaining weight despite lowering calories and doing exercise/sweating daily?

    • Bonnie says

      Hi Jen:
      This was me exactly a couple of years ago with SIBO for 8 miserable years and a very slow motility. It took 13 hours to digest a meal. My doctor thought I had Gastroparesis, but I didn’t. My slow motility went away when I started to take a Thyroid Pill, I was very surprised. I had no idea that this would make such a HUGE DIFFERENCE in my digestion. And this slow motility is what caused the SIBO. Make sense?


      • vb2005 says

        Hi Bonnie,
        It seems thyroid is the root cause of sibo – you can heal sibo temporary using antibiotics, elemental diet maybe fasting – but it will return if you dont fix the underlying problem – thyroid. So i dont understand – when you fixed your thyroid/ motility – this should cure SIBO – why you needed iodine? Maybe you need iodine for thyroid – not to kill bacteria?

        • Bonnie says

          Hi Jen:
          I had to go and look this up. I’ve never heard of Thyroid causing SIBO and will have to go back and read the whole page. What is there in the natural thyroid hormone that can cause such a devastating problem. No the Iodine came first because I wasn’t given the Thyroid for months after. I joined the Iodine Group at Yahoo which was run by Dr. Brownstein’s patient and he is the author of the Iodine book. So I started off with Lugol’s Solution 5% and took only 1 drop per day for a week and the 2nd week, 2 drops per day and 3 drops per day by the 3rd week and what left first was the overwhelming nausea after meals. That was gone but I still had slow motility but NO NAUSEA. Once I got on the Thryoid pill all digestion issues left. Before I could NOT eat after 12 noon, now I can even eat in the evening. I’m very happy about that but didn’t know about Thyroid CAUSING IT. Thanks a lot, but if more people would at least give Iodine a try, it might help.

          • vb2005 says

            Hi Bonnie,

            Do you know what king of hypothyroid is yours – maybe Hashimoto?
            There is definite link between slow thyroid and sibo. Here are some studies:


            There is study from: Gut, 1971, 12, 172-177 called Thyroid hormones and the gut?

            It is clear that excess or deficiency of thyroid hormone may affect all levels of
            the gastrointestinal tract and that the resultant changes may have clinical
            as well as biochemical relevance.

            Another one:
            Hindawi Publishing Corporation
            Gastroenterology Research and Practice
            Volume 2009, Article ID 529802, 7 pages
            Research Article
            Does Hypothyroidism Affect GastrointestinalMotility?


            Hypothyroidism prominently decreases gastroesophageal
            motility, and as such, thyroid functions should be evaluated
            in patients admitted with complaint of dyspepsia.

            • Bonnie says

              I called around and found a pharmacy in the city that carried a brand from Xenex Labs that are both here in Canada and also in Ferndale, Washington and that is the brand I use. It is distributed thoughtout Canada to various Pharmacies, so you would have to call ahead and see if they can get it in for you. In the US I would call the company to find out where it is available. My 4 oz bottle was $8.00 and lasts about a year. I was once taking 16 drops per day to shrink some fibroids. Here in Canada Iodine is not restricted like it is in the US. not sure if there is an S in there or not. If it doesn’t work, take the S out.

      • Jen says

        Bonnie! I too have horribly slow motility and tested negative for gastroparesis. I am on a low dose Armour Thyroid that I had to plead my Dr to give me. My TSH and free T3/4 are all low normal nothing drastic but my Thyroglobulin # is sky high. Are you taking anything for your thyroid besides Lugol’s??

        • Bonnie says

          I don’t have any Thyoid Antibodies, I think my gut (FINALLY) is working normally now. While my Free T’s were low normal, I did not feel very energetic, so I went to the online Thyroid Group who looked at my numbers. They gave me guidelines for the numbers that I should have, so i increased my dose again. WOW, that did it. Now I feel like Wonder Woman. LOL

          • Jen says

            That is great. I have NO antibodies either but my levels and cortisol and estrogen are all low normal and my DHEA was lowest it could be. It registered as a 88 yo when I am in early 40s. I am wondering if I need a higher dose of Amour and iodine. At this point the Autoimmune Paleo diet for two years did not even help much. I am feeling a bit hopeless today–tomorrow I know I will be different.

            • Bonnie says

              I take DHEA (a tiny amount) topically every single day to support hormone production (downstream) and my Adrenals as well. I take a tiny amount of Pregnenolone to make Progesterone for me, rather than simply taking Progesterone as I once overdosed on it. I feel much stronger with the DHEA. To help support leg vein circulation I take Grape Gold from Primary Source in Connecticut. I would not be where I am today if I stayed at the Thyroid dose,I was given initially. I listened to what the Thyroid Group had to say and increased from 1/2 grain that,the doctor put me on very slowly to the 2 grains, I’m taking right now. This is all determined by blood tests of course. In another 6 weeks, I will do another test and if the numbers are not where they should be, I will increase again. If doctors,insist on using ONLY the TSH, we will all remain unwell as the Range is way too big. At my Lab it is 0.5 to 5. So if your test is 4.9 they won’t do anything. Where I live in a remote village this is the way it is done here, so I had to find myself a smart doctor in the city. A LONG drive but worth it. All I have to do is phone and ask for a blood requisition to be mailed to me and go to a lab locally. You need to be in chargemof your own health, right?

  5. Marianne says

    I just completed the Vivonex T.E.N. elemental diet. I drank on average 5 per day at 1500 calories. I did the breath test at my doctors office on the morning of day 15. My numbers came back all ZEROS across he board!! According to this the SIBO is gone. So, now what to eat?? My doc said to follow the Low Fermentation Diet SIBO/Diet as outlined by Dr. Mark Pimentel, but also said to stay away from fruit and veggies the first 4 weeks. He said the bacteria not only feed on sugar but also fiber. Seems this is a complicated area. I believe more research needs to be done in the area of Post-SIBO diet with at least a year of follow up with patients. To me that is the key to lasting success. Good luck to all!

    • Lee says

      I did the same, couldn’t confirm it was SIBO. Did it anyways. I had an extra packet or two here and there to keep from being to lethargic and lose to much weight. The study was done using 1500 calories though, if I remember correctly.

      Did you end up tossing it in the freezer to reduce the taste? It was the only way I could bare it. Whatever though, desperate times call for desperate measures. Success rate is super high, its just the whole adherence lol.

      There is also a high chance that within the year it may come back. If it does and you kept with the diet, the next time around you may want to try a prokinetic, it should stimulate the migrating motor complex.

      • Marianne says

        I had the breath test earlier this year that confirmed SIBO, so this was great news for me. I have been taking Erythomycin 50 mg. and 9 Moltipro a day for motility although the gut is still sluggish. Presently my doc wants me to stay away from fruits and veggies (fiber) for the next 4 weeks. Problem is it makes it harder to poo.
        I just had my Vivonex on the rocks and added more water to dilute. In fact I’m still drinking about 3 a day to supplement my calories. Surprisingly even though it doesn’t taste that great, I’m able to drink it down just fine.

  6. Barbara says

    mu gastro doc wants me to have a capsule endoscopy done…I am afraid his will get caught and not come out…also have had this gassy crampy feeling for close to two years
    Have lost about 15 lbs as eating makes me feel worse…I live on chicken,turkey eggs
    I tried the xifaxan once and it worked well. Came back and didn’t work. I am at. Y wits end to find some relief. I go to the bathroom frequently also…some days it is hard to get out of the house
    Does anyone know of a doctor who specializes in sibo in New Jersey?
    Any other info would be greatly appreciated
    Thank you

  7. Shasta Michaels says

    Question on the elemental diet… biggest problem with this is the protein content. Can a person increase the level of protein and what can be used? I’m a bodybuilder and I’m fairly certain I can handle this liquid diet for three weeks (I’m very used to extremely strict diet regimens of stuff that tastes terrible, my will power with food is thru the roof) but I need above average amounts of protein, and calories, really. But I’m mostly concerned on protein. What can anyone tell me about this? And can something like pea protein be used? No carbs in that, I’m more than happy to have dextrose as a carb source in that homemade version. I hope someone can answer. Thanks in advance.

    • cream says

      Hi Shasta,

      I don’t know about protein but if your bacteria are in the upper part of small intestine dextrose will feed them – dextrose is just powdered glucose and they use glucose to diagnose sibo.
      Dextrose is not working for me but raw eggs give me great improvement – i think this is the most easy to digest food existing that does not feed bacteria – but only if they are raw.
      If they tasted better i would eat only raw eggs – they definately help with building muscles too.

      • Bonnie says

        Liquid Iodine (Lugol’s Solution 5%) will kill bacteria, anywhere in the GI Tract. I did for me. And took only 3 weeks.


      • Shasta Michaels says

        The homemade elemental diet calls for dextrose as a carbohydrate source so it must work for this application? I’m guessing it wouldn’t be suggested in the recipe if it caused issues, maybe it’s used because it absorbs almost instantly? I don’t believe it stays in the gut very long at all, particularly if disolved in water. Also, with bodybuilding, protein is very important but so are carbohydrates so going without can be a problem. I’ll probably opt for the low carb version of this elemental diet.

      • Shasta Michaels says

        The homemade formula calls for dextrose….it absorbs almost instantly so I doubt they’d recommend it if it was horribly problematic. I started this diet nine days ago and I’m mostly using organic honey, but I do mix a small amount of dextrose in with the aminos so I can choke the stuff down. Ugh….tastes wretched. Couldn’t hang with that so reduced the aminos and have been using pea protein. I think eggs were causing a reaction so until I heal the leaky gut I won’t be trying eggs. So far so good, I’m doing this for four weeks.

  8. Bonnie says

    “Seniors often have unreqognized SIBO resulting in malabsorption and subsequent B 12 deficiency. SIBO has been reported to affect 15 to 50 percent of older adults. B12 deficiency in this disorder is caused by the uptake of B12 by microorganisms in the small intestine.”

    Taken from Sally Pacholok’s book, could it be B12.

  9. Bonnie says

    On April 6 th Elizabeth asked me a question, but beneath her email was NO REPLY BUTTON, so I cannot figure out how to contact her.

    I want to say that the Iodine Protocol is not MY protocol and wanted to give her instructions on where to go. So if you read this Elizabeth, write me again?

  10. says

    Hi I have sibo for almost 7 years I live in the UK an find the doctors useless when treating this condition had antibiotics buy they didn’t work have followed the scd fo about 6 months was going to try either vivonox or absorbplus it is expensive and I cannot find a supplier in the UK has anyone had a permanent cure from either of these or know of a supplier in the UK
    Thank you

    • Bonnie says

      I had SIBO for an agonizing 8 years but got rid of the Pathogenic bacteria from using just 3 drops daily of Lugol’s Iodine and 3 weeks fixed it.

      Then I was prescribed a Thyroid pill which increased digestion speed which was the cause of the SIBO in the first place. When Digestion is very slow, the food rots and causes all that bacteria.

      Easy to figure out.


      • Kim says

        Hi Bonnie,
        Did you work with a practitioner that recommended the use of iodine? Would love to know more.
        Thank you,

        • Bonnie says

          Hi Kim
          The MD (in Michigan) that wrote the iodine book, saved the life of Stephanie who had Thyroid Cancer. She later became an ND, took over the Iodine Group at Yahoo and I worked with her starting 4 years ago.


    • Anna says

      Hi Janice, I have done my 14days elemental diet using Nutricia’s Fortisip (Nutridrink). You can buy it online in the UK but it is quite expensive. I bought mine through a Polish online pharmacy and paid 3 times less than in the UK, the 14days treatment incl. shipping would be around 150pounds. But you will need to ask someone Polish to help you order them since their website is only in Polish.
      The elemntal diet cured by sibo for around a year but then it came back. I have now bought a book The Gut Balance Revolution and just began following Dr Mullin’s protocol for SIBO. good luck

  11. Sara says

    Instead of having a liquid only diet that is super expensive, can’t one eat some actual foods or does everything impact what’s in the small bowel? I know if I am not full and lose too much weight (can only spare 5lbs max) I will become very aggressive.

    • says

      I think, as usual, everyone is different, but in my experience, my methane SIBO is diminishing with a steady course of real food diet and some supplements (Allimed, berberine, L-glutemine, probiotics) and pharma antibiotics (rifaximin…but CAUTION I’ve for sure become more sensitive to more foods due to this use…I now experience oxalate overload after finishing my last round and so I won’t do that again). I eat autoimmune paleo, low FODMAPS and low oxalate.

    • Denis says

      You may try just bone broths if you like. That was the initial suggestion or diet I was given by the Boucher Naturopathic Institute in Vancouver BC..

  12. Anne Best says

    I have been on the elemental diet for 8 days. My vision is worsening. I take vitamins for my eyes and have continued while on the elemental, but I wonder if they are getting absorbed with just the liquid food?
    I do not know if I should continue to the 14 days given my eyes.
    Any ideas?
    I am considering the option of eating a piece of meat at night and taking the vitamins with that.
    I know this sounds kind of crazy, but I am worried.

    • Deborah says

      My gastroenterologist suggested adding in an elemental formula to my diet. For the first time in years I felt happy.& functional as something had kicked in brainwise. However my eyesight worsened within a few days and my eyes were itchy and becoming sticky.and cloudySo I wonder if the formula was feeding the Klebsiella overgrowth I have. I’m taking antibiotics :( and they are improving.

  13. Denis says

    I started with botanical antimicrobial. After three months of trying different herbal formulas including Biotics FC Cidal with Biotics Dysbiocide, Microcidin, Allicin and other herbal concoctions. ,
    In addition to following a very limited SCD/FODMAP diet, grass fed beef bone broths, supplements Prescript Assist, Pure Encapsulation 950 Multi Vitamin, Fermented Cod Liver Oil, Saccharomyces Boulardii, Enzymedica Digest Gold, HCL,Magnesium Citrate,Iberogast,5-HTP,MCT Oil, etc. Unfortunately my SIBO symptoms did not improve with the SCD diet, herbal antimicrobial and supplements. What surprised me the most is that with such an arsenal I still have motility issues.
    Out of desperation I started a week ago Dr. Allison Siebecker’s elemental diet. The mixture is pretty disgusting and borderline nauseating. I am having a hard time meeting the dosage requirements. I usually drink it twice a day instead of 3 times a day. On the positive side, my sleep quality has improved and my SIBO symptoms have diminished. I think candida might be creeping in since my tongue has a white coating but unsure.
    Note: It has been a long and exhausting journey that started with parasitical infections combined with mercury toxicity, H Pylori, Candida and now SIBO.

    • mvarrin says

      Interested to know how you do. I have a theory that the people who actually heal don’t ever need to visit these sites again and so we’re left guessing. I finished many many months of prescription and botanical antibiotics and while my SIBO methane measurement went down by half, I’m now even more intolerant to more foods. I believe the ABX wiped out more essential bacteria. I’m going to try homeopathy and then either elemental or FMT. thx.

      • Denis says

        Sure, I will keep you posted. I am in the same boat high methane producer. Chris Kresser has said on a previous podcast that methane producing archaea is to blame. These prokaryotes are hard to eradicate or reduce their numbers. It may take more than 6 months to have symptoms improve. I am also interested in FMT but can’t afford the 10000 $ procedure. In addition, apparently remission rates are debatable. Best course of action is to remove, rebuild and reintroduce. It seems unfair that the medical industry is so caught up with curing cancer but autoimmune diseases fall by the wayside. When you have an auto immune issue it seems like a life sentence of poverty.
        Good Luck and keep me posted on The FMT.

        • Sue says

          Hello Dennis. I just starting learning about sibo a few months back so please tell me what is fmt. Thanks.

          • Sue says

            Denis please accept my apology for misspelling your name. Just to be a little more clearer on my earlier question, i am referring to the FMT procedure that costs $10,000. Thanks.

            • Marianne says

              Denis, 10k for fecal transplant. That’s outrageous. How many transplants does that include and who are you going to for that price?

                • Denis says

                  Sorry for the long absence. I managed to sustain the STED diet for 2 weeks. My SIBO symptoms were greatly improved while on the diet but other symptoms worsen (dermatitis and insomnia).

                  After 2 weeks I could no longer stand the pain from the dermatitis. I spoke to my doctor and we concluded that either it is candida that is worsening or liver detoxing or both. I don’t know if it is scientific fact but toxins may have been released from such a restrictive diet.

                  I am still having issues,unfortunately it did not work. On a positive note cholesterol levels have improved from the Fodmap Paleo diet.
                  I am currently supplementing
                  540 mg of Allimax 2 times a day
                  2 Integrative Therapeutics Berberine Complete 3 times a day
                  sometimes diatomaceous earth
                  Pure encapsulation Multi 950
                  3000-4000 fish oils epa/ dha
                  and liver support l glutathione and 600 mg of milk thistle

                • Denis says

                  I forgot to mention that my blood panel revealed that my white blood cell eosinophil are chronically high. That is interesting to note because they are involved in combatting parasitical infections yet my doctors data stool test was negative.

                  Yes I do follow a very restrictive low FODMAP diet. I am conscious about histamine producing foods and try to limit its consumption.

        • Shasta Michaels says

          There’s an FMT clinic in Portland OR that has more reasonable rates and they have their own donor bank too so you don’t have to ask friends or family for “donations”. Ew! I can’t recall the name of the place but maybe it’s worth looking into?

      • says

        Denis–hope you’re doing better. curious, did you do low FODMAPS? And how much bone broth? I try to get 3-5 mg. of L-glutamine a day via broth and powder supp. These are the only elements you don’t have in your list that I do and I think I’m on a slow, but steady healing path.

        • Denis says

          I do supplement with Jarrow L glutamine between 1-2 tbsp a day. In addition I will add 1 tbsp of collagen in my tea or coffee. SCD type gelatine seems to upset my stomach. Maybe it is the Welch grape juice, I don’t know or I am just hyper sensitive to sugars in general.

          No raw vegetables just soups, meat and fat.
          I have concocted great recipes through the years. I don’t feel I am missing out.
          It is ironic how much saturated fat I am eating and yet my cholesterol is improving.
          Go figure, I am a believer that it’s the sugar that is making people sick and fat.
          Deep fried foods are not the greatest either but I do like my oven broiler and Ronco”s rotisserie cooker. I can’t live without.
          I make my own fresh young coconut yogurt, I take 1 oz everyday. I use to eat home made sauerkraut. I follow recipes and use their jars. You can make your own jars quite easily. Wine store carries the air lock and window/glass store can drill the hole in the glass lid and the silicone grommet can be bought online or a Lordco or other automotive parts store.

          Fermenting is important for replenishing good bacteria but some of us are sensitive to the histamine they contain.

          I digress, I do supplement with many antioxidants but I cycle and did not want to add to much to my list and scare off some readers. Ubiquinol Coq10 is another supplement I take with my fish oils

    • Bonnie says

      Hi Kiki:

      Yes, I cured my SIBO using Iodine 2 – 3 years ago. And I keep it away, by still using it every day. It was very simple and worked within a month. Thank goodness, I’m rid of that after 8 years of suffering nausea and bloating. Now I can eat whatever I like. You can read all my posts about how I did it in July 2014.

      • Sharon Hanna says

        Bonnie – can you tell me where to find what you are talking about from 2014? Thanks. I have a friend who has had recurring bladder infections as well as sinus problems (and prob other things) – I want her to know about iodine.

        • Bonnie says

          Sharon, SCROLL DOWN till you come to July 2014 and you will see 3 or 4 Posts of mine with my name BONNIE in dark letters. You can’t miss it.

        • Bonnie says


          Did you find my posts about Lugol’s Solution 5% (Iodine) and do you have any questions? I’m thinking of just cancelling this subscription about the SIBO problem. No one is listening. It’s NOT that complicated, you have too much bacteria in certain places, in the body and Iodine kills bacteria. Works quickly too, but it looks like people would rather try special diets, antibiotics and whatever instead.

          • vb2005 says

            Hi Bonnie,

            The situation with iodine is not so simple. I for example am very thankful to people like you who share such valuable information. But iodine sound too dangerous to me and after some research i found that you have to be very careful what you take for thyroid. Here is some info from Mercola com:
            In fact, I don’t generally advise taking iodine supplements like Lugol’s or Ioderol, because your thyroid only transports iodine in its ionized form (i.e. iodide). Your thyroid reduces iodide (I-) into iodine (I2) for use in formation of thyroglobulin. Your body doesn’t utilize iodine directly. It has to split the I2 into two I- ions, which is an oxidative reaction that causes oxidative stress.
            So if you tell people that you used some food rich in iodine to heal your sibo i am sure much more people will try it. But most people are not experts in iodine and i guess they are just afraid to try it.

            • Bonnie says

              Yes, of course. I was afraid too. But I was so sick of being nauseated, bloated and tired and thought about it for a year beforehand. The Iodine group has over 9,000 members and we’ve cured a lot of our problems. Have you seen my list that I posted on July 19th, that made such a difference for me? Our list owner is a former patient of Dr. David Brownstein that wrote the Iodine Book – Why You Need it and Why You Can’t Live Without it. She is now a Naturopath. Dr. B cured her of Thyroid Cancer using Iodine (Lugol’s Solution) and every 3 mo I did Thyroid blood tests to see what was happening there. I went VERY SLOWLY with one drop per day. I’m very glad I did.

            • Bonnie says

              Hi, don’t see your name anywhere. Don’t believe what Mercola says, there are still people out there that “don’t get it.” We have over 9,000 members on the Iodine List at yahoo(even some with Hashimoto’s) RUN by a Naturopath that was cured of Thyroid Cancer by the doctor that wrote the IODINE BOOK, and we are ALL BETTER NOW. Come and take a look.

      • Dale says

        There is no cure yet for SIBO. Iodine especiallly has no role in erasing SIBO but it can erase your pocketbook

        • Bonnie says

          Hi Dale:

          What Iodine DOES DO very well, is it KILLS OFF the Bacterial Overgrowth which causes so many symptoms.

          As for being expensive, It costs me about $10. for a bottle that lasts about 18 months. Since I live in Canada, Iodine is not restricted here, like it is in the US.

          I think this Forum (unless I’m wrong) is ALL ABOUT BACTERIA, right?

          I think it is just too simple for people to grasp.

          • vb2005 says


            Do you know if iodine kills only bad bacteria or all bacteria? If it kills only bad bacteria and it works this means that the whole theory of SIBO is total BS /that SIBO is good bacteria in the wrong place/

            • Bonnie says

              Our chemistry- whiz on the iodine Group explained the other day how Mercola has it wrong. If you write me directly I can pass that on to you. Also Iodine does not kill good bacteria.

      • Theresa says

        Hi Bonnie,
        I’m glad that taking iodine worked well for you. My elderly mother was battling SIBO so on my recommendation began using iodine. It wasn’t doing helping so we went to a functional medicine doctor. Among other things, testing revealed Hashimotos and, of course, high thyroid antibodies. When we removed the iodine the antibodies lowered considerably. Her SIBO was treated with a product called Microb-Clear plus a strict diet. I recommend taking iodine only under the guidance of a professional who can do testing to make sure you aren’t causing other problems with it. I am glad that it worked in your case.

        • Bonnie says

          You get yourself a bottle of Lugol’s Solution 5% (Iodine) and put 2 or 3 drops of the Iodine in water or juice each day. Give it at least 3 weeks.


    • Lisa says

      i tried Iodine for 4 weeks. Didnt do much really. I stopped bc I got gastritis back. Im going resume lugols iodine in 2 weeks again, skipping a full 4 weeks. I’ll come back and update this thread.

  14. Lynn says

    Anyone have experience treating Ankylosing Spondilitis (Klebsiella bacteria implicated) as SIBO? Have been on no starch diet for 6months, able to reduce meds, but am still too uncomfortable without then entirely. Also doing probiotics daily, tried grape seed suppliment, gave up on garlic. The slightest mistake with a food sends me backwards in terms of pain and stiffness for approx 1 wk or more. Planning to try Biotics Research herbal formula.
    Would be willing to do elemental diet but no access to product where I live out of the US. Is there a way to just make your own without commercial products?
    Any suggestions welcome.

    • Evan Eberhardt says

      I also have ankylosing spondylitis. I have been low-starch for 3 years (thanks to Carol Sinclair’s IBS Low-Starch Diet) and that by far has helped the most. No iritis flare-ups in that time frame, however, the stiff morning back comes and goes as does other various body pains. If I go full paleo minus all starch my pain declines nearly all the way after a couple of weeks. However, I start to lose weight (I am already too skinny) because I cannot eat enough no matter how hard I try (I REALLY miss potatoes as they were something I ate all the time growing up and were a great source of calories, even more so than bread). I did about 45 days of the Biotics Research dysbiocide and fc-cidal and didn’t notice much of a difference taking those (except I got a headache about every other day). I am also curious if the klebsiella reside in the small intestines or if they are in the large. I am about ready to try the Marshall Protocol next.

  15. Mitch says

    I had recently got blood results back that said I have a high level of vitamin B12, and I also have Peripheral Neuropathy. After doing research, I found that most likely I have Sarcoidosis and pain caused by small-fiber neuropathy. I would like to know what diet, supplements, and probiotics, ect. would I most likely benefit from. Please help, Greatly Appreciated!!

    • Heidi says

      Have you checked for MTHFR gen mutations? Basically your body doesn’t use the B12 so it builds up in your liver. I have this mutation and have to take supplements in order for my body toget the B12.

    • JJ says

      High levels of B12 are common in people with SIBO even if they aren’t consuming enough. See research confirming this.

  16. mia says

    Did anyone try vital HN instead of Vinonex plus for sibo. I hear that it is the same as vivonex plus and taste much better.

  17. Aurora says

    I have recently been diagnosed with Sibo in the past two weeks & I’m doing as much independent research as possible, thank you all for the lively discussion! I am still debating whether or not to go ahead with my doctor’s 10 day Neomycin & Flagyl protocol, followed by at least 90 days of Dr. Pimentel’s New IBS Solution Sibo diet. I have pretty much eaten some variety of keto with the occasional cheat for the past few years & I don’t even miss things like bread, rice & potatoes… I miss pizza & pasta occasionally, but hey, I’m half Italian >;-).

    I learned from one of my doctor’s staff members that she has only begun treating Sibo in patients a matter of months ago, & given how long I’ve suffered misdiagnosed, never really knowing what was causing my symptoms for years on end, I would like to put a final end to it & live life from full health! I prefer to put my trust in a doctor with a good track record with healing Sibo. So I am looking for recommendations in the NY/NJ area, though my current doctor is in CA, so I’m not opposed to elsewhere as long as the doctor has a good track record. Thank you in advance!

    • James says

      The diets in Dr. Pimentel’s book are outdated and unhealthy. Try the low SCD or low fodmap diet. These are specifically for sibo.

        • Shasta Michaels says

          Yes! Yes! Yes! I found this diet and it’s working well for me in the very short time I’ve been on it! Fast digesting carbs don’t seem to cause problems. As a bodybuilder it was depressing me to think I had to cut out all my starches and carbs and give up bodybuilding (veggies alone won’t provide enough energy for this and won’t fill out the muscle bellies). This Fast Tract diet is a lifesaver, provides variety, and makes WAY more sense…..and SIBO sufferers have had really good results.

  18. Brock says

    Kelsey, the amino acids that Dr. Siebecker recommends, taste horrible in powder form, can I put the powder in a capsule? Thanks

  19. vb2005 says

    According to if you drink strained orange juice – it will not feed bacteria because it is rapidly absorbed – anyone tried this? I tried it but dont feel better – but this can be due to other problems related to fructose.

  20. Rita says

    What is the possibility of using the elemental diet and food? I desperately need help. I have lost a pound a week for the last 5. I have an Endoscope scheduled for this coming Monday and am thinking at this point it is probably cancer. I feel horrible. I am concerned about a regular protein shake messing up my Sibo, but need to gain some weight. Any thoughts? Thank you for any help.

      • Rita says

        I am doing better than I was then. I had the Endoscope. It was not cancer. Nothing showed up but mild GERD. I went on the Xifaxan for a month and improved a lot. The brain fog diminished considerably and my SIBO symptoms also. I was able to gain the ten lbs. back I had lost. But I am not doing as well again. The SIBO has come back though not intensely, probably because I continue to eat nothing but chicken, turkey, carrots, beets, Jasmine Rice, bone broth, and drink a hemp protein drink. I am suspicious of the drink being a cause of the extreme brain fog and fatigue I am now experiencing. I have cut it out to try to see if there is less fatigue and brain fog. But to have that limited a diet and not a lot of improvement is very discouraging. I have been living on special diets most of my adult life. I have had Chemical Sensitivities for over 35 years, and have taken extreme care with foods during that time including elimination of wheat, dairy, nuts, carbs, sugar, fruits. I am also sulfur sensitive and that has eliminated most vegetables. I have mercury I have been trying to get out for years. The mercury has done in the adrenals and the thyroid. For the chemical sensitivities I wear a mask when out and have a filtration system going 24/7 in the house. I am ready to be rid of it all and am desperately searching for some answers. Yes, I tried iodine, too. Not for SiBO but for my thyroid. Learned that in some people it lowers the thyroid production. I am one of them. That was another bad experience.

  21. Tanya says

    I took one round of Xifaxan for SIBO after a breath test came back positive for hydrogen, which didn’t do anything for my chronic bloating and constipation issues. Oddly, the only thing it did was eradicate the foul rotten egg smell from my gas (which is great in and of itself, but I need my other symptoms to go away!). My subsequent breath test came back negative for both hydrogen and methane; however, my doctor thinks I should take Xifaxan/Neomycin for 14 days, as he believes I may have bacteria that produce hydrogen sulfide, which the breath test doesn’t measure. Is anyone else in a similar predicament? I’m really nervous to take the Neomycin as I don’t have a confirmed positive breath test, and I would hate to make matters worse by further reducing my gut flora.

  22. Bonny Thomason says

    I have been diagnosed with sibo 3 yrs ago. I am so gassy I can’t live with myself. I live in Minneapolis mn and I would like help to guide me what to do.

    • Bonnie says

      Hi Bonny, to see how I got rid of my SIBO, (and more) go back up this list and start reading my posts beginning at July 19th.

      • Kim says

        I’ve been suffering with SIBO for 2.5 years. I’ve seen 12 health professionals both Western and Eastern practices and still having incredible distension 2 hours post meal. I’m hoping some information on his site will guide me to treatment that will work. I am considering elemental diet.

        • Bonnie says


          I have posted several times on KILLING OFF Gut pathogens using Lugol’s Solution 5% (Iodine) look at July.

          I can’t seem to get anyone to listen. Is it just too simple?


          • Gloria Owens says

            Hi, Bonnie, are u referring to the ‘descaling’ solution for coffee makers? I’ve suffered from SIBO since 2007 and will try almost ANYTHING at this point, but this seems a bit out there! But, then, so is SIBO and it’s symptoms.
            For those whose primary sibo symptom is constipation, PLEASE look at ldn (low dose naltrexone). Some remarkable results there.

            • Bonnie says

              No I am not referring to descaling a coffee maker. I am referring to KILLING OFF GUT PATHOGENS with Iodine that has been in use for almost 200 years. I had Nausea and Bloating for 8 years and life was awful at times. Within 3 weeks all that LEFT ME after starting a couple of drops daily of Iodine – Lugol’s Solution 5% Does it sound TOO SIMPLE? Maybe, but it works.. No one is listening either.

                • Bonnie says

                  I started off with one drop DAILY of LUGOL’S Iodine 5% and after a week, started with 2 drops daily and by the 3rd week I was taking 3 drops per day and that is when all the NAUSEA left me after 8 years of suffering.

              • Valerie Whetstone says

                HI BONNIE,


                • Bonnie says

                  Where you buy Lugol’s 5% Iodine Solution depends on what country you live in.

                  So let me know and I’ll try and help you.

              • Amber says

                Hi Bonnie,
                Did you take the iodine on an empty stomach, or does it matter?
                Do you eat a normal diet now or do you do anything specific to avoid recurrence? Do you continue iodine use, if so, what’s a safe maintenance dose?

                • Bonnie says

                  Hi Amber:
                  Sorry I must have MISSED this email of yours. You can take Lugol’s Solution 5%, with or without food. I would suggest that you join the Iodine Group at yahoo where they have experts and a Naturopath to guide you. Let me know if you have trouble finding this Forum. Write me and I’ll help you.

                • Lela Kurtz says

                  Bonnie, well you convinced me to try it.. I have started a mulit- herbal antimicrobials, the soil bacterias, and the non lactate acidophilus pre and probiotis. I have problems with constipation most of my life and have been on a Paleo diet for almost 2 years. Was doing much better until I had a 1 alcoholic drink when out with friend 2 months ago and things have gotten worse since then.. Was down to 99 lbs before they finally took out my Gall bladder which had given my pancreatitis. This resolved and gained 20lbs. I now have lost 8 lbs again.. just because I am afraid to eat very much.. I live on Organic Chicken and Bone Soup.. so other meat and cooked greens.. with a few carrots, yams and butternut squash with my soup.. So I am going to start the iodine today… I had already bought it when I bought all my herbs for the Sibo treatment.. So will see if the iodine will make a difference.. I haven’t been tested for SIBO but have been tested for everything else and when your bowels just stop working I think it is a good sign, it is a bacterial overgrowth. Will let you know if this works and how well it is tolerated

  23. Shari says

    I have done 2 rounds of Rifaximin and have been on herbal abx since January to treat Methane dominant SIBO. I did 2 weeks of the homemade elemental diet in June, it seemed to clear the bacteria from my upper small intestine but concentrated it in lower small intestines (those numbers were higher than ever). Starting round 2 of the homemade elemental diet today. It’s not that bad or expensive considering the cost of everything else I’ve done. My ND from the SIBO Center in Portland says you can substitute protein (eggs, beef, chicken, etc) for one elemental meal a day and do the diet longer, 3-4 weeks. Protein must be prepared the same you do during breath test fast, plain with only salt and pepper for spices.

  24. Julia says

    I have done the 2 weeks Rifaximin/Neomycin and then had 10 FMT treatments and still have SIBO symptoms!! What are the recommendations for after treatment diet/care/protocol? I was told after FMT to introduce more safe starches to feed the good guys, but still have SIBO bacteria…that I should be starving? I tried the GAPS/SCD diet before treatment, I am extremely underweight and can’t do such low carb anymore? What should I do now for diet, treatment etc?

    • John Es says

      Might you have bacteria hiding out in biofilm, a periodontal pocket, or an infected tooth?

      Is your migrating motor complex sufficient to keep SIBO from recurring?

      “Eat more safe starches” seems like pretty non-specific advice, and I’d want more detail. Different safe starches are going to provide different prebiotics or perhaps none at all.

      I’d figure out whatever calories help you gain weight while having minimal aggravation of symptoms, and journal diet, bowels movements, symptoms, and exercise until you can get more professional help.

      Did you get FMT at a clinic of some sort? What country?

      • Julia says

        Thanks John Es

        What helps the migratory motor complex? I read I think on the seibeckers website that LDN helps with this? I actually just started taking it. Do you know if it does or then what else would help with it?

        I did get FMT out of country. I went to the Taymount clinic in the UK and had 10 treatments!!

        I don’t know what to do now…diet, did I just into sweet potatoes and plantains too soon and should stick to SCD/paleo longer? but want to feed to the good guys and put on weight as well? and then how would I treat the SIBO now at this point….again?

        • John Es says


          I thought your treatment combo of antibiotics and FMT sounded brilliant. I’m sorry it didn’t work out.

          I wish I could be of more help, but, I am not anything like an experienced practitioner.

          Chris explained the mechanics of LDN in an old podcast. The context was different, but, I’ll try to track that down and see if it’s informative. Seems like it had something to do with opioid receptors and autoimmunity.

          Thanks for your follow-up.

        • John Es says

          Another thought on MMR. I’ve read where people have used activated charcoal to measure their transit times. Another thing to journal. :^P

          • Julia says

            Yes I heard the podcast on LDN and have started it for auto-immune issues. But also thought I read on dr. Seibeckers site that it helps MMC. Do you know of anything else that helps the MMC?

            • John Es says

              Off the top of my head, I think I heard Dr. Siebecker mention probiotics to help MMC.

              Another thing that comes to mind is the stuff typically mentioned by functional and integrative practitioners, starting with thyroid function, and including HPA axis regulation, and liver function. Gut pathogens and barrier function, are typically covered by their testing.

              My current plan is to see a practitioner, probably an FDN person, or, perhaps a Kalish method person.

      • Shari says

        Try putting your feet up on a step stool or even a box, that’s what we do in our house. At least that way you’ll know if it’s beneficial for you before you spend the $$ on the squatty potty.

        • John Es says

          I guess I could have mentioned, my take on the squatty potty is that it is “better than nothing”. I find it fairly awkward, and still getting used to it, after several weeks. I would rather just put a newspaper on the floor, and squat, but, the clean-up is a bitch.

          Looks like you might get the cheap model for about $25. I didn’t pay much more than that, at Bed, Bath, and Beyond in the US.

    • says

      Hi, you made me feel sad after reading your protocol, i was planning to also do excacty that,2 weeks Rifaximin and Neomycin and then 10 FMT treatments, i thought this is all it would take, i cant believe it failed for you:((im sorry)
      I have heard some people claim that taking probiotics puts sibo in relapse after antibiotics treatment because the natural MMC(migrating motor complex)of the body is still recovering and might take 3 months, so the probiotics dont get flushed down to the lower colon and bring SIBO back, my plan is to do FMTs which will put the probiotic bacteria only in my lower colon and take MMC tablets every night before bed for 3 months to push the bacteria from the FMT out the small intestine if they try to move upwards.
      Have you tried a full anti parasitic herbal treatment?
      have you been diagnosed with SIBO or are you treating it based on symtoms?

    • Dave says

      I read your post and am in a similar situation..
      Many rounds of RIFAX – 5 FMT treatments;
      Eat Carbs to grow the good bacteria – and the SIBO returns – or perhaps comes out of hiding.
      I’m not sure what the path forward is…
      Perhaps we ate carbs to soon. Did you do bottom up or top down FMT – I wonder if top down does a better job?

  25. Bonnie says

    We now know that skin health is closely related to gut health, so I would bet that many people with SIBO (Celiac Disease or Gastroparesis etc.) will also have a skin condition of some kind.

    So according to Dr. Jonathan Wright (near Seattle) you treat Eczema with Culturelle probiotic and Rosacea with extra Hydrochloric Acid.

    • Ken says

      What about psriosis?

      I never read about correlations in regards to that and sibo, which I have both of unfortunately. Is there something specific for that as well?

    • Amber says

      I agree with the gut-skin connection. I’m hoping if I can manage to treat my intestinal issues, that my bouts of acne will stop.
      Has anyone here successfully resolved their skin problems via fixing their gut?

      • Shasta Michaels says

        I’m currently on the elemental diet and I’m on Day12. I decided to go for 4 weeks on this. It sucks pretty bad but seems to be working. I have noticed my skin is definitely improving the further into this diet I get. My skin was dry as anything and NOTHING helped. Also had skin fungus patches that NOTHING helped. Both are improving. I hope it continues to go this way.

        • Kim says

          Hi Shasta,
          Did you make your own Elemental Diet formula or did you purchase it? If you made your own, did you follow the formula on Any details you could share would be appreciated.

          • Shasta Michaels says

            Yes, I’m doing the homemade version. After seeing the ingredients and price tag on the pre-made stuff I was like “no way!” And no, I’m not following it exactly. I’m a bodybuilder and I have higher protein requirements and didn’t want to lose any more muscle mass than necessary so I added a non-GMO plain pea protein powder, which also helps dull the wretched vomit-like taste of the amino blend. Using a combination of honey and dextrose for the carb source…..a little dextrose in the shake, also to help improve the taste, and a spoonful of honey a couple times a day. Also using medical grade manuka honey to help kill off bad bacteria. For fats I rotate between MCT oil, coconut oil, and macadamia nut oil.

            I ordered a stool test that revealed I have overgrowth of three bad strains of bacteria so pretty sure that’s what the problem was, probably due to antibiotic use in the past.

            I’m rotating herbals every four days for maximum effectiveness and utilizing a biofilm distruptor. Plan to stay on this a total of four weeks. So far things are working well, I’m not feeling hungry, I must have my calories correct because weight is staying on target, I have ceased all workouts while I heal this problem so my body can focus on healing. Also, I know I have leaky gut syndrome so I’ve added L-glutamine (a bodybuilding supplement I use regularly and always have on hand!) and my last “meal” of the day is a big cup of hot organic beef bone broth that I get at a local butcher shop that makes it to standards for digestive tract disorders. Supposed to really help the healing process.

            I’m on Day 16 and seeing/feeling a big difference, the extreme bloat has gone down as well as the overall water retention I was experiencing. Trying to address a hormone imbalance and possible sluggish thyroid while I do all this. I do have some belly bloat but that may be a side effect of the elemental diet and should subside once I start eating solid food again. I will say one thing, I have willpower of steel when it comes to food, so sticking to this isn’t a problem for me but it’s been hard, the die off symptoms at first were no less than brutal and the lack of energy was horrible. Right at the two week mark this past weekend I felt a huge shift and started feeling WAY better. Still got a couple more weeks but happy I’m doing this, very hopeful this will be effective, but I still plan to watch the diet for quite a while just in case. I eat super clean anyway so this isn’t an issue.

            • vb2005 says

              Hi SHasta,

              Here is another source of protein – i think it is not protein but keto acids:

              First juice raw potatoes with juicer – after 10 minutes the starch will go to the bottom of the cup with the juice. Then move the juice without starch in different cup and boil until most water evaporates – what is left is protein of potatoes – i think 1 kg of potatoes have 30 grams proteins. It tastes bad but with salt is better – this is called Ray Peat potato protein soup – Ray Peat say it boosts thyroid also

              • Shasta Michaels says

                Very interesting! I’d try it if I had a juicer, but I don’t and don’t plan on purchasing one anytime soon. The pea protein powder is working great, the cost is low, and I use it as a regular bodybuilding supp anyway since I react to whey protein isolate. They do have flavored pea protein now but the sodium content is much higher so I stick with plain. Pea protein digests quickly and rarely do people have reactions to it, it’s not hard on the digestive tract at all so although it tastes sorta like cardboard, it works for me.

  26. Bonnie says

    On July 19th I posted my success in killing off all my gut bacteria (after suffering nausea for 8 years) within only 3 weeks. I should have said I used IODINE instead of Lugol’s Solution which is the real name.

    It is so simple but no one seemed to notice. Why go through years of a special diet, when IODINE (a couple drops a day) will kill the bugs, bacteria, fungus, viruses and treat many other conditions as well such as fibroids, hypothyroid, ADHD, etc.?

  27. Schmemilypie says

    Can someone explain to me… If SCD is supposed to reduce the bacterial load of SIBO by removing sugars that bacteria can feed on, how does the Elemental Diet work differently (and faster) than SCD? Is some ingredient in the Elemental Diet working to destroy bacteria? I know this must have been explained somewhere, I just can’t seem to find it in the article or comments.

    • John Es says

      The nutrients are more broken down, and thus absorbed higher in the small intestine. Elemental diets are typically amino acids, fatty acids, vitamins, and simple sugars – nothing more complex.

  28. Lynette Schmaltz says

    Does anyone know of any Dr’s in the St. Paul/Minneapolis area that can help me test for SIBO and understand the Paleo Approach?

  29. says

    I feel like I once heard that structural misalignments could cause SIBO on a podcast. Was wondering it the person knew what they were talking about or not. Could going to a chiropractor help to relieve SIBO symptoms? If anyone knows about this let me know just seems like another avenue maybe worth exploring.

    • John Es says

      In the context, the vagus nerve is usually discussed. I think it could be a underlying factor, affecting digestive enzymes, motility, for some. Do a little googling, and you’ll find plenty of stuff.

      • Bonnie says


        The Vagus nerve can be a big problem and I was given Domperidone, thinking that I had Gastroparesis. But I thought why take a drug for slow motility when Iodine will kill the bacteria and the slow motility can be addressed with a thyroid pill.

        • John Es says

          I’m a little hypothyroid, and living in the Western world, so, chances are good that I have Hashimoto’s.

          If that is truly the case, iodine would probably be contraindicated. I wouldn’t take it without having my antibodies checked. I believe iodine can cause a Hashimoto’s flare, and promote destruction of the gland.

          Plus, if I can find the root cause of my hypothyroidism, maybe it could be corrected, and I wouldn’t need supplemental thyroid hormone.

          I’m still in the early stages of investigation, and I actually suspect that I have a T4 -> T3 conversion issue, and neither Hashimoto’s, nor iodine deficiency.

          I appreciated your information, and will add iodine to my list of options.


          • Bonnie says

            If you took a look around on the Iodine list at yahoo, you would get information from others who have successfully used Iodine to treat Hashimoto’s. The list is run by a Naturopath who was a patient of Dr. David Brownstein ( who wrote the iodine book and 10 others) and cured her of Thyroid Cancer. We now have over 8,000 members and you would find all your answers there. Very few of us users of Iodine haver ever tested.

  30. Balázs says

    Chris, how the elemental diet compares to VLC specially in GERD? How long a VLC should be followed to get similar result?


  31. einstein says

    Here is a fast, efficient and cheap method I learned fm Andre Van Lysbeth. Get his Yoga book to check the exact method with pictures. I used this before a colonoscopy to make my large intestine ready for inspection and the doc said he never saw such a clean one before. Use at your own risk.

    Prepare 3 liters of moderately salty water (1 tablespoon for 1 liter).
    1-Drink three to five 200ml cups of this water.
    2-Stand with your legs slightly spread and raise your hands above your head. Bend four times to the left and right (starting out to the left side) in succession so that the water gets into the small intestine. This exercise opens up the valve between the stomach and the small intestine.
    3-Stretch your hands out in front of you and twist your torso four times to the left & right side alternatingly. During this exercise, the water advances in the small intestine.
    4-Place the palms of your hands on the ground, with the body stretched out and only the tips of the toes touching the floor. Look four times in succession across your shoulders, at the opposite heel. This moves the water from the small intestine to the large intestine.
    5-Squat down and (4 times alternatingly), put one knee down on the floor in front of the other knee. This will press the thigh of the knee which is NOT down on the floor at that moment to the left and right halves of the lower abdomen. With this movement we push the water in the large intestine all the way to the anus.
    Repeat exercises 2 – 5 a few times till you feel the urge to go to the toilet.
    After the first toilet session, continue like this:
    Drink one cup of salty water, do 1 series of exercises 2 to 5, go to the toilet.
    By the time the 3 liters of salty water are spent, nothing but clean water will be coming out of the anus. The digestive tract will be perfectly clean.
    Be ready to go to the toilet a few more times after you stop drinking the salty water.
    Once the regular water flow fm the anus stops or nearly stops, eat a normal meal (paleo/primal of course :-).
    This will close the still open valve between the stomach and the small intestine.
    Do not drink for at least 1 hour after the meal. Then small amounts of water can be taken. A few hours later all will be back to normal. Don’t expect any stool for a day or two.

    Once you start this cleansing procedure, there is no way to interrupt it safely. The salty water needs to be pushed through the digestive tract before it gets a chance to be absorbed into the bloodstream. It is a pretty gross method and holding your nose, fighting throw-up reflexes etc. are a normal part of it. I have no idea about its effects on people with chronic conditions like high blood pressure, diabetes etc. I would recommend it for otherwise healthy individuals without acute digestive problems.

    • Scott says

      Hi EInstein,

      can you please tell me the exact name of the Yoga book, I’ve found several books from this author.


      • einstein says

        Hi Scott,
        I’m afraid I don’t know the exact title of the book, because it was a Czech edition, which I had in the beginning of the 80’s, orange cover, just titled Joga. Must have been published around 1984. I lent it out to someone like 20 years ago and never saw it again. I still remember the technique because I did it a few times (the last time was 6 years ago) and wrote it down so I won’t forget it.

      • einstein says

        Hi Scott,
        after a bit of googling I found the following:
        This description of the postures can be consulted more in detail in the book of Andre Van Lysebeth: “I improve my Yoga”.

        The description of the technique is the same as mine, with different words. Hope it helps. Cheers!

  32. Evan E says

    What would a 7 day fast achieve I wonder? All the SIBO critters would be starved by then, right? Why even bother with Nestle’s GROSSLY overpriced concoction (have you seen the prices on Amazon? It’s like $13 a packet!). Perhaps follow the fast with a SCD diet and colostrum and l-glutamine supplementation?

    I am assuming this little meal idea was used just because fasting is not given much attention. But a week without food is not a big deal for most people (even those underweight). It kicks the body over to ketones for fuel and all sorts of other interesting things begin happening (hunger is typically gone by day 3). Seems like a simple experiment that could be done. But if the SIBO returns it’s critical steps be taken to curb that, otherwise what is the point long term?

    • einstein says

      those critters will survive longer than you. no fast beyond 3 days shoud be undertaken without medical supervision.

      • Evan E says

        And you say that because? Have you ever fasted? Have you seen how long humans can survive without food (as long as water is available?). I have personally witnessed a man do 40 days. The body can draw upon stores, the bacteria cannot. How would they survive longer, ‘einstein’?

        • einstein says

          Hi Evan,
          my comment was meant to be a bit sarcastic. Sorry about that. I do fast regularly but never went beyond 36 hours. I don’t doubt you’d survive longer than for 7 days if you had to, but I do doubt that it would benefit yours or anybody else’s health unless you have a very good reason for it (pre-chemotherapy fasting comes to mind) and are under medical supervision. From what I read more than 3 days mean muscle wastage, zero energy, metabolic slowdown, inability to focus and not much ability left to anything meaningful (work etc.). And I doubt that sheer willpower can get a man to do a 7 days fast. I might be wrong about this, because I’d be munching tree bark by then if nothing else was available and consider myself to have quite a lot of willpower :-)

  33. PC says

    Would a ketogenic diet not help SIBO? I would imagine it to have a similar effect as an elemental diet if done for a long enough period?

  34. Linda Barrett says

    After doing a year of several antibiotics with only occasional short-term relief, I went Paleo/low FODMAP. After three very long strict years with an occasional cheat (for which I suffered greatly each time), I am able to add back a few fruits and “clean” ice cream occasionally. Probiotics, L-glutamine, and peppermint capsule each day also help me feel great. As a teacher, being away from school in the summer helps bloating for sure as well!

  35. Bill Lemke says

    Hello Kelsey,
    nice article.
    One question:
    Wouldn’t fasting be ideal for strarving those bacteria?
    (And even fungus)

    • Bonnie says


      You can kill the bacteria and fungus and still eat whatever you like with a couple drops of Iodine daily. Very simple.

  36. Bonnie says

    I would like to say that I suffered for 8 years with nausea and bloating after meals which caused a weight loss of 70 lb. during that time. After much reading I realized I had a small intestinal bacterial overgrowth (SIBO) and completely eliminated all my symptoms within a month by taking several drops daily of Lugol’s Solution 5% and fixed a few other problems I had as well.

    • Bee says

      Bonnie, can u elaborate more on the iodine protocol? What time of day did u take it? With food or empty tummy? Did u use other supplements (some say adrenals need to be addressed first or Selenium and other minerals need to be added too)….? Lastly, what did u use for ur thyroid to address motility issues? My doc recommended triquench iodine

      Did u have any side effects, like anxiety, from iodine? How intense was the die off and are u still on iodine?

      • Bonnie says

        About 3 years ago I thought that if all this discomfort could be caused from having too much bacteria in my gut then I had to figure out how to get rid of it. I was diagnosed with Gastroparesis and given a drug which worked really well but I wanted to do it without drugs or antibiotics, so I surfed the net.
        I read many articles and joined an SIBO list at yahoo I think. These people had various conditions which caused SIBO and dealt with it by drastically changing their diets, taking drugs and/ or antibiotics several times a year but never really getting rid of it.
        I don’t know how Iodine came into the picture for me but I remembered when I was a kid how iodine killed germs on cuts and scrapes, so why couldn’t it kill germs in my gut? I had read where people took it internally so I found an iodine list, joined and began asking questions.
        I could see that people were having Detox issues by their bodies getting rid of Bromide, Flouride and Chlorine ( while taking iodine) so I planned to go very slowly. So being very worried, I started off with only one drop daily of Lugol’s Solution (5%) and the following week (every Friday) I would increase it by one more drop. On the 3rd week – wow, the nausea was completely gone.
        I still continued to increase weekly until at 16 weeks I was taking 16 drops per day, in the morning on an empty stomach. I didn’t want food to be in the way. I stayed at this dose (100 mg) for a year. During that 16 weeks I had some amazing health issues disappear which I could list in another posting.
        My digestion was still slow and someone mentioned my thyroid, so I looked into testing and sure enough the numbers were low but my doc thought they were just fine, so I got a new doc and a prescription for Erfa. After fixing my Adrenals, things went well but I reacted to the fillers in the Erfa and had to have it compounded. After increasing the thyroid meds my digestion is now
        I am still taking the iodine and I never had any detox side effects, doing it that slowly.

  37. Jason says

    I did a juice fast, (carrots/celery only) for 11 days along with clay and other anti-bacterial, anti-parasitic supplements. I did feel great and went from bad to good bowel movements but the problem is the loss of weight and adherence to the program. Also while the gaps/scd diets do help people, there is such adherence which is crazy. I would not recommend all the Nestle elemental diet things. That’s just toxic in itself. I believe juicing with carrots/ginger/celery/cabbage/greens are very beneficial to the body and should be part of a health diet to heal. I was eating a lot of sushi and feel I went backwards in my program. I believe too many bugs/parasites/viruses hitting my body and if the body is slightly weak at the time, then they will take hold. Also the mercury is definitely a no no. I’m off the sushi for good now. I read too much about the ill effects on thyroid and mercury. Once your thyroid and or adrenals are impacted, then you are going to put your body in a vicious cycle. I’m back on the mend though and doing much better.

  38. Honora says

    Reading about the elemental diet treatment reminded me that I have met inflammatory bowel patients who were on a study where they consumed ‘ensure’ type formulas as their only source of nutrients. Surprisingly they were able to be compliant. I found that amazing in itself.

  39. Bee says

    Would a juice feast work to solve sibo and yeast overgrowth? (veggie juices, little or no fruit)? Perhaps supplements with Thorne Mediclear plus, aloe, and probiotics, systemic enzymes, and oregano and cats claw? That’s a plan I’m considering

    Another thing that keep in mind is hcl levels, and also a sluggish or faulty motor complex. So, addressing adrenals and thyroid can help too, as well as b12/d

  40. Anon says

    I once inadvertently did a VERY thorough gut microbe cleansing when I inadvisedly swallowed a whole garlic clove like a pill. Near as I could tell from the results afterward, I killed off all my gut flora. My bowel movements were just some nasty liquid, not even really diarrhea. I didn’t start getting normal/solid feces again until I started taking some probiotics. So I have been leery about eating garlic ever since! I still eat it, but try not to overdo it.

  41. John Havey says

    I have that white coating on my tongue that Chris described. So maybe my problem is fungal, and I am hoping you will also do a write-up on symptoms, mechanisms, and treatments for fungal issues.

  42. Rene says

    I’m wondering if you’ve ever used calcium bentonite clay to treat SIBO. I’ve had gut issues ever since I had Cushing’s syndrome and afterward took steroids and statins for about 6 years. I have been drinking hydrated clay four times a day on an empty stomach for about a month now and have experienced a great improvement. In particular, most of my bowel movements are normal, and my intolerances to most all foods have disappeared. Would be interested in your reaction to this therapy.

    • shari says

      Nutrients have to be predigested so I would say no. Having things predigested insures that your body will absorb them quickly and leave nothing for the bacteria to feed on.

  43. Andy says

    I’ve done the elemental diet multiple times.

    I actually have an article from pubmed where they tested gut flora levels each day someone was on an elemental diet.

    In summary, it appears to affect Lactobacillus spp. after one week, but other levels in the colon were not statistically significant.

    Maybe if it was longer, one would see a big change, but 2-3 weeks may not be long enough to have this effect.

    Thanks for the article

    • Andrea says


      Could you please post the link to this article… just curious about how they obtained samples of the flora from the small GI each day? That is not easy to do. I would love to present this to my GI doc.


      • Andy says

        The name of the article is ” Effects on an Elemental Diet on the Faecal Flora in Patients with Crohn’s Disease”

        it should be easy to find

  44. says

    Monolaurin works well, I think the issue with tolerance to herbal antimicrobials is the “die-off” or Herxheimer reactions. I have seen practitioners manage this with things like activated charcoal, proteolytic enzymes, reduced glutathione, testing for MTHFR mutations, general liver/biliary support

    • Andrea says

      Hi Alex,

      Could you elaborate more on the MTHFR mutations please and how it relates to SIBO treatment? I have Factor 5 leiden, and SIBO, and not once have doctors said those relate. Curious about your thoughts?


  45. Risa says

    My 10 year old daughter has SIBO (my diagnosis). It has been extraordinarily difficult to get any information about SIBO in children and testing is virtually impossible. Per Chris’s advice, we started her Prescript Assist in addition to a FODMAP/Paleo diet. In less than a month she had significantly improved. Now, about 5 months later, she has the bowel function of a normal child. However, it can still be a challenge to maintain a FODMAP/Paleo diet with a 10 year old. I can’t even imagine trying to get her to follow an elemental diet. I wish more discussion would focus on kids with SIBO. My guess is there are many parents with SIBO kids who have no idea what to do with them. My daughter is from China, so we tried a lactose free diet, an auto-immune protocol, and strict Paleo. Nothing helped her at all until we combined FODMAP and Paleo.

    • Caitlin Russell says


      Did your daughter work directly with Chris? I have a 9 year old with SIBO and feel the same frustration with lack of guidance for children. Perhaps we should start a Facebook support group?

    • Andrea says

      Hi Risa,

      I have been diagnosed with SIBO and my 5 year old son. We both took Xifaxan b/c we have been doing Paleo for 5 years and not getting better. He did allergy testing recently and is allergic to many of things. Although allergy tests can yield funky results, we knew they were accurate b/c his mouth and throat swell and GI starts getting super upset after eating certain foods. He has eosinophilia and allergies to nuts, dairy, gluten, oats, peanuts, corn, soy shellfish, citrus EGGS (that one is super hard to give up since Paleo’s reliance on it for most foods) That said, have some allergy testing done. If your daughter’s gut is super inflamed by things such as nightshades, or eggs, Paleo diet can be a nightmare. So we are on GAPS diets and see more success with strict diet over anything else.

      My son did fine on Xifaxan and we were very happy to see improvement but his allergies will persist until gut is healed. (For me it is a longer road.) His pediatric GI doc also has him drink oregano tea (literally oregano steeped in water) This is a new territory for GI docs and I have been working very hard with them to get things right. (we see docs at Stanford who actually seem very open to alternative healing)

      I did the elemental diet for two days… that was enough and I was super super committed to do it… however i just vomited it up and really sick. Not the best solution in my experience. Probably not a good idea for little ones.

      I still struggle with SIBO daily and it is just a chronic dysfunction until the root of the issue is better understood. I don’t think doctors or other healers have a handle on this issue so until then, you are your best doctor when you listen to your body.


      • Michael Andeson says

        Hi Andrea. Can u email me please ASAP about sibo and symptoms. I’m looking for someone to talk to and share my experience with

  46. Jean Tuthill says

    Can the elemental diet be helpful if you dedicate a few days a week to it and then eat “clean” foods other days.. grass fed protein, organic greens etc. Maybe even doing this in combo with herbal anti-parasitic supplements or to try to prepare the gut before or after an anti-parasitic regimen?

    Or even do a few days a week when trying to heal a leaky gut?

  47. John Es says

    As you mention, is a great resource, full of detailed information and references.

    Listening to many functional medical practitioners, they talk a lot about stool testing, and the prevalence of false negatives. It doesn’t seem like many of them use the lactulose breath test, which might be more reliable in detecting the bugs in the small intestine that often don’t get into the stool samples.

    At this point, I am using betaine HCl and digestive enzymes to try to overfeed myself, and get my weight up before trying some combination of elemental diet, SCD, and possibly even fasting. Getting tested should probably be part of the plan.

  48. Caitlin says

    Good summary of a complicated subject matter!

    Wondering if you have experience with using both Rifaximin and elemental diet at the same time? Or would that be too much? Or do one first and then follow up with the other treatment: ie. Rifax first for 2 weeks then elemental protocol for 2-3 weeks.

    Thanks Kelsey!

    • says

      I don’t have experience with that (not a doc, so don’t deal with prescriptions!) but my guess it it would be a bit overkill. I’d go for rifaximin first if that’s what you wanted to try.

    • Simas says

      If I remember correctly, according to Dr. Pimentel antibiotics work best, while the bacteria is still feeding, meaning that you have to eat real food, and that also means no SCD diets while on treatment.

    • Deb says

      In his book, Pimental says that the Rifax only works on bacteria that are replicating (ie eating/thiving) so doing the elemental diet at the same time is contraindicated.

  49. Joel Thiessen says

    Surprised to see such low figures for the effectiveness of the antibiotic approach – Siebecker (whom you mention in your post) touts a success rate of 80-94% for different antibiotic regimens.

    I noticed this since I’m currently taking rifaximin for exactly this reason, having already tried the elemental diet. The diet was effective but made me too sick to continue for the full 2 weeks.

    • says

      Perhaps she’s referring to her own success rates in her practice (which includes dietary changes as well), while studies that study just rifaximin treatments (no dietary changes) may have lower rates. Not sure, but that’d be my guess.

    • Fiona says

      Shouldn’t we all be extermely careful about becoming resisitant to antibiotics except where they are essential for lifesaving conditions?

    • Simas says

      Dr Siebecker is probably refering to the studies by Dr Pimentel, which I’m pretty sure he gets such rates, because they always adjust for methane producers, meaning that they give rifaximin+neomycin. Which significantly increases succes rates, in people who produce methane gas. Rifaximin does not work for methane.

  50. Simas says

    I know some people get constipated after this kind of treatment. Also, I believe it is possible for SIBO to be so high up in the intestine that it could still feed it. And you did not mention those with insulin problems. One would consume huge ammounts of starch, and that doesn’t sound too good. I’m also struggling because I can’t tolerate herbals… That’s a huge problem….

  51. Marian Gain says

    Just reading the first line of the ingredients of Vivonex is enough to turn me off, and make me angry. I was considering purchasing lysine in supplement form, and yesterday discovered that most chemically made supplements at the health store that I was at were derived from corn. Not GMO-free, or pesticide free.
    And from Nestle, a company we can all trust!? RIGHT.
    First they create the problem, then they get rich off their garbage solution, and create a whole new raft of problems.
    I am exploring Functional medicine solutions, but now wonder about vested interests.

    • penelope says

      Wow, thanks for this reminder! Are capsules also likely to contain corn? is it the filler or the actual active ingredient. Did you find some clean lysine? I have been using NOW (brand).

      • Marian Gain says

        Penelope, There were 4 or five different brands at my local store, and all were derived from corn. Lysine is in lots of different foods, so that’s probably where I’ll get mine.
        This whole temporary fix, instead of determining cause and eliminating all possible triggers is just another rabbit hole ( to get lost in).
        Are we 100% sure that it’s bacteria? What about viruses?

  52. says

    In attempt to save money would it be possible to do some sort of protein restricted fast with protein shakes? That way maybe you can save yourself some dollars by only buying maybe one or even two supplements to mix into your concoction. Just wondering if this would be feasible as long as the protein had a minimal amount of crap in it and assuming you don’t have an allergy to it i.e. whey protein.

    • Shasta Michaels says

      I’m doing the elemental and could NOT hang with the vomit flavor of the amino acids, and I’m a body builder so I wanted to preserve muscle mass and I have higher protein requirements than the average person. So what I’ve decided to do is reduce the amount of aminos to half what I was using (reduces cost too) and added plain pea protein powder (tastes like cardboard). Makes the aminos a tad less disgusting to and the protein is fast digesting and doesn’t cause me any problems or irritation. I don’t know what others would have to say about this but it’s working for me.

      • Kim says

        Hi Shasta,
        Checking to see how you are doing. Did you finish the elemental diet? Any details you could share is appreciated!

        • Shasta Michaels says

          YES! With great success! I’m still on a supplement for motility, addressing a hormone imbalance and taking some iodine and selenium for the thyroid. My belly fat is melting off as a result of this!!! I found the book Fast Track Digestion IBS with an eating plan for SIBO that has been hugely successful, most of the other diets (FODMAP, etc) aren’t quite right for SIBO but this one goes by the fermentation potential of various foods and rates them. So far it’s working for me very, very well and allows for more variety in the diet. My belly is flat for the first time in over two years, and inflammation and water retention are down to a human level. I’m back to bodybuilding and feeling better than I have in a very, very, very long time. Plan to do everything in my power to prevent this from relapsing but so far I can eat gluten free white bread, certain types of rice, certain fruits, and red potatoes (among other assumed “forbidden” carbohydrates) with no issues….amounts have to be watched but it made no sense to me that traditional SIBO diets eliminated carbs to the degree they did. The depression of thinking I wouldn’t be able to bodybuild was overwhelming….you HAVE to take in carbs to bodybuild!! So I’m overjoyed that I can make this work since this is my passion. I’m also still taking a small amount of herbals once a day that I’m rotating just in case I still have some bad bacteria in there. I refuse to let this become a problem again!!! And I really do recommend that book, if anyone is interested the website is

          There are links to the book, but I got a used copy off for $8…..if you have amazon prime you can “borrow” an e-copy at no charge to see how you like it first. This diet approach makes WAY more sense than the other popular SIBO diet approaches for sure. There are two different books, the IBS version of the book is the one you want for SIBO problems, it sort of encompasses IBS as a whole and the various conditions that cause IBS. There is also a small section that addresses athletes and their need for carbs so I have to say, this book literally brought tears to my eyes when I found it! Happy, happy, happy girl here!

          I stayed on the elemental diet for a full four weeks and also addressed my leaky gut syndrome at the same time. So far I can eat eggs with no problems at all. I’m not really willing to test the water with other foods that were causing problems but I have a hunch that I healed up a ton of damage in there on the elemental diet! I rotated my herbals every four days so that the bad bacteria wouldn’t be able to adapt. I also religiously took a biofilm disruptor about 15-30 min prior to taking any herbals, and I also used medical grade manuka honey to help kill off bacteria (this stuff kills the MRSA virus, people! Use it to your advantage! I took it 15-30 min after the biofilm disruptor and would just take 1-2 teaspoons. But order off amazon and get a higher medical grade and read up on the stuff! It’s astounding in it’s capacity to heal and also kill infection!)

          Will my SIBO come back? I don’t know. But I am hopeful that I have this beat and that my current approach will prevent relapse.

  53. Nicky says

    The “it’s temporary” part is nestled in there like an afterthought. How long does it last before symptoms come back?

  54. says

    I’ve used the AbsorbPlus Elemental Diet shakes to address my IBD before I found the Autoimmune Paleo Protocol. These shakes have a very clean ingredient list and are also pretty tasty. You can add in MCT oil for extra nutrients/calories, too. The book “The IBD Remission Diet” by Jini Patel Thompson has helpful info about a healthier elemental diet.

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