Natural Treatments For SIBO
Herbal treatments are excellent for reducing the symptoms of SIBO. I have used herbal and natural treatments to treat microbial overgrowths of all types in my patience for almost a decade, and I can assure you that these tools work every bit as well as antibiotics.
What I’ve seen in my patients for years was demonstrated in a 2014 trial. Patients with SIBO were either given the drug Rifaximin or herbal therapy for 4 weeks. The researchers measured breath tests and tracked symptoms before and after treatment.
At the end of the trial, the group receiving herbal treatment were more likely to have normal breath tests.
46% of the herbal group normalized their breath tests
34% of the group receiving the antibiotic normalized their breath test
The researchers went one step farther and offered additional therapy to patients who didn’t respond to antibiotics in the first 4 weeks of treatment. When a patient taking Rifaximin didn’t achieve a normal breath test, they were either offered the original herbal treatment or an intensive new regiment of three different antibiotics (clindamycin + metronidazole + neomycin).
After further treatment:
60% of Rifaximin non-responders given herbal triple antibiotics then achieved a normal breath test
57% of Rifaximin non-responders given herbal treatment achieved a normal breath test
As you can see, the group receiving herbal therapy had nearly equivalent results as the group taking three strong antibiotics showing that herbal therapies for SIBO can be every bit as effective in eradicating SIBO as antibiotics.
Are herbal treatments safe?
Yes! In the study above, the researchers carefully tracked side effects.
Herbal treatments clearly came out on top - the antibiotic Rifaximin led to 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhea, and 1 case of Clostridium difficile.
Herbal treatments caused only 1 case of diarrhea.
What natural treatments do you use for SIBO?
In my practice, I commonly start out with a combination of natural treatments. My go-to non antibiotic treatment is usually a combination of garlic extract and monolaurin. I’ve found that this herbs has been very effective at reducing symptoms and improving breath tests in a variety of patients for almost ten years in my patients, and very rarely cause problematic side effects. Another of my favorite combinations is pairing oregano with a broad spectrum herbal blend.
It is my experience that oregano and garlic are both effective at reducing the bacteria that cause elevated methane levels on a breath test. patient who has methane dominant SIBO. These cases tend to have worse symptoms, more constipation and are slower to resolve.
The main reason that I tend to combine therapies in my patients is that they work better.
It turns out that many herbs have synergistic effects when added to other antimicrobials. I have seen this to be true when adding herbs to standard SIBO antibiotics, and also when treating patients with multiple agents at one time.
I am not alone in these observations - there is an increasing number of scientific research focusing on how adding naturally derived compounds can improve, as in the paper shown here.
Note on Berberine
Although the nutraceutical berberine is often recommended as a natural treatment for SIBO, my experience has been that the higher doses of berberine needed to reduce bacterial counts almost always give patients cramping, diarrhea and headaches. (I do like berberine at a lower dose of 500 mg twice daily for patients with insulin resistance and related metabolic problems.)